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題名 | Phenylephrine試驗在眼瞼下垂患者的應用 |
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作者 | 馬俐; 高錦弘; | 書刊名 | 中華民國眼科醫學會雜誌 |
卷期 | 31:1 1992.03[民81.03] |
頁次 | 頁41-49 |
分類號 | 418.2323 |
關鍵詞 | 眼瞼下垂; 交感神經刺激劑; Phenylephrine test; Ptosis; Muller's muscle; |
語文 | 中文(Chinese) |
中文摘要 | 觀察結膜腔內點藥後,眼瞼提瞼功能的大小變化,進而研究藥物作用的 位置。是目前眼整形科一個很熱門的題目。本文即利用一種交感神經刺激劑 (Phenylephrine)點入結膜腔內,觀察對於各種不同原因引起的眼瞼下垂的患者的反 應。分析整理,找出眼瞼下垂的機轉以及開刀的參考。 本文共收集了74人,93眼,分成17組。包括1.正常人,11眼。2.ゝ先天性眼瞼下 垂,12眼。3.老年性眼瞼下垂,26眼。4.重症肌無力症,3眼。5.長期戴隱形眼鏡 導至下垂,6眼。6.腦血管病變,1眼。7.ぃ再發性霍納氏症候群,2眼。8.白內障 術後眼瞼下垂,3眼。9.翼狀贅片術後下垂,1眼。10.外傷性下垂,4眼。11.原因 不明之再發性下垂,4眼。12.假性眼瞼下垂,3眼。13.甲狀腺亢進眼瞼上縮,8眼。 14.經提瞼肌截短術後,5眼。15.經提瞼肌後徙術後,2眼。16.經苗勒氏肌切除後, 2眼。17.外傷後接受前額懸吊術的患者,1眼。 點藥後眼瞼提升高度平均小於1.0mm的有第2,10,13,14,17組;眼瞼提升高度 平均在1.0mm至2.5mm之間的有第1,4,6,7,11,15,16組。反應強烈眼瞼提升 高度平均大於2.5mm的有第3,5,8,9,12組。 此一試驗可以應用於臨床的部分,除了可以瞭解患者眼瞼下垂是提瞼肌或是苗勒 氏肌功能不良引起,同時在開刀前遇有phenylephrine試驗陽性(>2.5mm)的患者, 在注射的局部麻藥中最好不要添加Bosmin,以免開刀中苗勒氏肌受到交感神經興 奮劑的刺激過度上舉,而在麻藥消失後,發生矯正不足的現象。 |
英文摘要 | 10 phenylephrine was instilled into 97 patientsto observe its pharmacological action on the eyelids.Phenylephrine is primarily a sympathomimetic agent.It causes direct stimulation at the muscle receptorsite. It haas been reported to elevate the upper lid2-3 mm in some ptosis patients. Patients were divided into 17 groupsincluding: 1. Normal subjects, I I eyes 2. Congenital ptosis, 13 eyes 3. Senile ptosis, 26 eyes 4. Myasthenia Gravis, 3 eyes 5. Ptosis following C.L. wearing, 6 eyes 6. Ptosis following CVA attack, I eye 7. Acquired Homer's syndrome, 2 eyes 8. Ptosis following cataract extraction, 3 eyes 9. Ptosis following pterygium excision, I eye10. 9. Ptosis following pterygium excision, I eye10. Trauma, 2 eyes1 1. Acquired ptosis (cause unknown), 4 eyes12. Pseudoptosis, 3 eyes13. Graves' lid retraction, 8 eyes14. Following levator resection operation, 5 eyes15. Following levator recession operation, 2 eyes16. Following MuUerectomy, 2 eyes17. Following trauma and frontalis sling, I eye Almost all of the patients, except in group 10,13, response to phenylephrine. The mean changes of vertical palpebral fissure in17 groups ranged from -0.2mm to 2.67mm. In group2, 10, 13, 14, 17, the mean elevations were less than1.0mm. In group 1, 4, 6, 7, II, 15, 16, the mean elevations were between 1.0mm and 2.5mm. In group 3,5,8,9,12 the mean elevations were greater than 2.5mm. The purpose of this study are (1) define the mechanism of the ptosis, whether the ptosis is induced by weakening of the levator muscle or Muller's muscle. (2) determine preoperatively the effect of epinephrine containing anesthetic solutions on the lid, and avoid the epinephrine in the mixture if the response of the lid higher than 2.5mm. |
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