目的 探讨表皮生长因子受体酪氨酸酶抑制剂（EGFR-TKIs）一线治疗耐药后,二线化学治疗（化疗）联合程序性死亡蛋白1及其配体（PD-1/L1）免疫检查点抑制剂方案对晚期非小细胞肺癌（NSCLC）的疗效。方法 选取2018年 6月—2022年10月期间就诊于南通大学附属肿瘤医院院的80例有完整临床资料、应用EGFR-TKIs耐药后晚期NSCLC患者进行回顾性分析,依照不同治疗方式将患者分为观察组与对照组,均为40例。对照组一线EGFR-TKIs治疗耐药后进行二线化疗,观察组一线EGFR-TKIs治疗耐药后进行二线化疗联合PD-1/L1免疫检查点抑制剂治疗。对比两组临床疗效及无进展生存期（PFS）,化疗前后血清中人细胞角蛋白21-1片段（Cyfra21-1）、糖类抗原125（CA125）、碱性成纤维细胞生长因子（bFGF）、血管内皮生长因子（VEGF）水平变化,不良反应发生率及生存质量。结果 观察组客观缓解率与疾病控制率高于对照组（P<0.05）,对照组PFS为10（2.38,24.13）个月,观察组PFS为14（5.27~,5.27）个月,观察组高于对照组（χ²=4.536,P=0.041）;化疗后两组bFGF、VEGF,CA125、Cyfra21-1肿瘤标志物水平均比化疗前降低,且观察组[（17.85±3.32）ng/L、（310.51±88.37）ng/L、（51.62±13.66）U/mL、（10.26±3.37）ng/mL]低于对照组[（19.62±3.24）ng/L、（366.26±49.42）ng/L、（59.26±9.35）U/mL、（12.62±2.73）ng/mL],对比差异有统计学意义（t₁=2.413,P₁=0.018;t₂=3.482,P₂<0.001;t₃=2.919,P₃=0.005;t₄=3.442,P₄<0.001）;两组不良反应发生率对比差异无统计学意义（P>0.05）;化疗后两组世界卫生组织生存质量量表简表评分均升高,观察组[（98.62±8.24）、（101.53±12.62）、（95.28±11.15）、（97.79±10.47）分]高于对照组[（84.25±7.32）、（93.58±15.75）、（82.24±9.34）、（83.47±8.38）]分,对比差异有统计学意义（t₁=8.246,P₁<0.001;t₂=2.491,P₂=0.015;t₃=5.670,P₃<0.001;t₄=6.753,P₄<0.001）。结论 对EGFR-TKIs耐药后晚期非小细胞肺癌患者采取二线化疗联合PD-1/L1免疫检查点抑制剂可提升其临床疗效及生存期,改善血清相关肿瘤标志物表达水平,提升患者生存质量。

Objective To explore the therapeutic effect of second-line chemotherapy combined with PD-1/L1 immune checkpoint inhibitor regimen on advanced non-small cell lung cancer（NSCLC） after epidermal growth factor receptor-tyrosine kinase inhibitors（EGFR-TKIs）resistance in first-line chemotherapy．Methods Retrospectively selected 80 patients with advanced NSCLC EGFR TKIs resistance,who were admitted to the Affiliated Cancer Hospital of Nantong University from June 2018 to October 2022．Patients were divided into an observation group and a control group according to different treatment methods,with 40 cases in each group．The control group received second-line chemotherapy after first-line EGFR-TKIs therapy resistance,while the observation group received second-line chemotherapy and PD-1/L1 inhibitor after first-line EGFR-TKIs therapy reactions and quality of live．Clinical efficacy and PFS,changes in serum levels of human Cyfra21-1,CA125,bFGF,VEGF,incidence of adverse chemotherapy of two groups were compared．Results The ORR and DCR of the observation group were significantly higher than those of the control group（P<0.05）．The mean PFS of the control group was 10（2.38-24.13）months,while the mean PFS of the observation group was 14（5.27-35.27）months．The observation group was higher than the control group（χ²=4.536,P=0.041）．After chemotherapy,levels of bFGF,VEGF,CA125 and Cyfra21-1 tumor markers decreased in both groups,and the observation group [（17.85±3.32）ng/L,（310.51±88.37）ng/L,（51.62±13.66）U/mL,（10.26±3.37）ng/mL] was lower than the control group [（19.62±3.24）ng/L,（366.26±49.42）ng/L,（59.26±9.35）U/mL,（12.62±2.73）ng/mL],which showed statistically significant difference in the comparison（t₁=2.413,P₁=0.018;t₂=3.482,P₂<0.001;t₃=2.919,P₃=0.005;t₄=3.442,P₄<0.001）．There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）．After treatment,the WHO QOL-BREF scores increased in both patient groups and the observation group scores[（98.62±8.24）,（101.53±12.62）,（95.28±11.15）,（97.79±10.47）] were higher than the control group scores[（84.25±7.32）,（93.58±15.75）,（82.24±9.34）,（83.47±8.38）],which showed statistically significant difference．（t₁=8.246,P₁<0.001;t₂=2.491,P₂=0.015;t₃=5.670,P₃<0.001;t₄=6.753,P₄<0.001）．Conclusions The combination of second-line chemotherapy with PD-1/L1 immune checkpoint inhibitors can improve the clinical efficacy and survival of advanced NSCLC patients who are resistant to EGFR-TKIs,improve the expression levels of serum related tumor markers,and enhance the quality of life of patients．

目的 利用靶向二代测序技术探究天津市发热呼吸道症候群病原特征,分析病原流行特征,总结规律,为发热伴呼吸道症候群患者治疗策略提供指导。方法 收集2023年1月—2023年12月天津地区某四家医院初诊为发热伴呼吸道症候群的4 039例病例,通过tNGS技术检测,分析鉴定病原微生物,研究不同标本类型病原微生物分布、年龄分布、性别分布、不同时间季节感染分布、微生物类型分布趋势等。结果 4 039例经tNGS技术检测,共检测出90种潜在病原体,总阳性率为94.80%（3 829/4 039）。包括36种细菌、29种病毒、5种非典型病原体和20种真菌。不同种类病原体检出频次排序：革兰阴性细菌（G-细菌）>RNA病毒>DNA病毒>革兰阳性细菌（G+细菌）>真菌>非典型病原体。男女性别阳性检出率比较差异无统计学意义（χ²=0.249,P=0.618）;不同年龄段人群病原体谱有异质性,且阳性患者多分布在0~10岁和>60岁,阳性也集中在该两类人群,阳性率分别为47.90%（1 834/3 829）和31.24%（1 196/3 829）。在单一感染中,肺炎支原体占比最高,为4.91%,其次为新型冠状病毒,占1.59%,再次为呼吸道合胞病毒,占1.23%。不同季节不同感染类型具有差异,整体呈现夏冬季混合感染率高的特点,即夏季新冠病毒合并细菌（鲍曼不动杆菌、肺炎链球菌）,冬季肺炎支原体合并甲型、乙型流感病毒多见。肺炎支原体对大环内酯类药物耐药率随月份呈现增加趋势。结论 tNGS 技术在天津市发热呼吸道症候群样本中获得了较高的病原体检出率,病原体覆盖面广,通过提供更多的病原体信息,可以有效辅助鉴别混合感染和耐药信息。

Objective Using targeted next-generation sequencing technology to explore the composition of the pathogenic spectrum of febrile respiratory syndrome ,analyze the epidemic characteristics of the pathogen,summarize the rules,and provide accurate guidance for the treatment strategy of patients with febrile respiratory syndrome．Methods By tNGS detection of 4039 cases with fever with respiratory diseases in four hospitals in Tianjin in 2023,pathogenic microorganisms were analyzed and identified,and the distribution of pathogenic microorganisms,age distribution,gender distribution,infection distribution in different times and seasons,and distribution trend of microbial types in different specimen types were studied．Results In 4039 cases,90 potential pathogens were detected,the total positive rate was 94.80%（3 829/4 039）,including 36 kinds of bacteria,29 kinds of viruses,5 kinds of atypical pathogen and 6 kinds of fungi．The order of detection frequency of different types of pathogens：G-bacteria > RNA virus > DNA virus > G+ bacteria > fungi > atypical pathogens．There was no significant difference in the positive rate of male and female between the two groups（χ²=0.249,P=0.618）．The pathogen spectrum of different age groups was heterogeneous． The positive patients were mostly distributed in 0-10 years old [47.90%（1 834/3 829）] and >60 years old [31.23%（1 196/3 829）]．Among the single infection,Mycoplasma pneumoniae accounted for the highest proportion,4.91%（188/3829）,followed by 2019-nCoV,1.59%（61/3 829）,and respiratory syncytial virus,1.23%（47/3 829）．There were differences in different infection types in different seasons,and the overall characteristics of mixed infection rate in summer and winter were high． In summer,the new coronavirus was combined with bacteria（Acinetobacter baumannii,Streptococcus pneumoniae）,and in winter,Mycoplasma pneumoniae was combined with influenza A and B viruses．The resistance rate of Mycoplasma pneumoniae to macrolides showed an increasing trend with the time．Conclusions The tNGS technology had obtained a high pathogen detection rate in the samples of febrile respiratory syndrome in Tianjin．By providing more pathogen information,it can be effectively applied to the etiological diagnosis of respiratory infectious diseases and assist in the identification of mixed infections and drug resistance information．

目的 通过分析2019—2021年广州地区保密性弃血工作情况,完善献血者献血后回告受理和保密性弃血管理。方法 通过分析广州市血液中心2019年1月—2021年12月期间受理的无偿献血者献血后保密性弃血回告记录,统计分析无偿献血者要求保密性弃血的各种原因,以及保密性弃血施行程序中出现的新情况。结果 2019年、2020年、2021年保密性弃血人数分别占当年献血人数的0.156‰,0.090‰,0.091‰。2020年之后出现接触或疑似接触新型冠状病毒患者的回告案例;在这3年间,87.6%的保密性弃血在72小时内完成回告。结论 无偿献血者保密性弃血回告以及血液屏蔽是保障血液用血安全的重要举措之一,目前广州市回告率相对较低,提示要强化血液保密性弃血回告及方法途径指引宣传,注意对新回告原因的收集以有针对性开展献血前征询工作,从源头筛选出合格、低风险的无偿献血者,同时完善长时间(72小时以上)才回告的血液保密性弃血处理程序。

目的 通过多种生物信息学方法分析MAML1在GC患者中的表达及与临床特征、预后和免疫治疗疗效的相关性。方法 利用TCGA数据库分析胃癌组织与正常胃黏膜组织中的MAML1表达水平;Kaplan-Meier在线工具对胃癌数据集GSE15459进行分析,阐明MAML1与患者临床特征及分期、治疗疗效的相关性;STRING软件预测与MAML1表达相关的基因,并用FUNRICH软件评估其富集的分子生物学功能和信号通路;TIMER和GEPIA数据库探索MAML1表达水平与肿瘤浸润免疫细胞及其相应基因标记集之间的关系。结果 MAML1在GC组织中的表达水平高于正常组织(P<0.001),且其表达水平与III期、有淋巴结转移、无远处转移的患者生存期相关(P<0.05),而与I、II和IV期、无淋巴结转移和有远处转移的患者生存期无相关性(P>0.05)。MAML1的相关作用基因主要分布在细胞核、参与转录调控,并且主要富集在雄激素受体、C-MYB转录因子和HIF-2α转录调控等相关的信号通路。MAML1表达水平与B细胞、CD4⁺ T细胞、巨噬细胞的表达水平存在正相关关系(P<0.05),但与肿瘤纯度、CD8⁺ T细胞、中性粒细胞、树突状细胞无相关性(P>0.05)。结论 MAML1有可能成为GC患者较差的临床预后标志物之一,其潜在分子机制可能与转录调控调节肿瘤微环境有关。

Objective To investigate the expression of MAML1 and its relationship with clinical characteristics, prognosis and the efficiency of immunotherapy in patients with GC. Methods MAML1 expression profile was observed by TCGA database. Kaplan-Meier survival analysis was applied to evaluate the correlation between the expression of MAML1 and clinical characteristics, prognosis and treatment efficiency of patients in GSE15459 dataset. MAML1-associated genes were predicted by STRING and were enriched in GO and KEGG by FUNRICH software. The relationship between MAML1 expression and markers of tumor infiltrated cells were explored by TIMER and GEPIA database. Results MAML1 was abnormally upregulated in GC tissues compared to normal gastric tissues (P<0.001). MAML1 expression was significantly associated with the overall survival of patients in stage III, with lymph node metastasis and without distant metastasis (P<0.001). There was no significant difference between MAML1 expression and the overall survival of patients in stage I, II, IV, without lymph node metastasis and with distant metastasis (P>0.05). MAML1-assoicated genes were mainly located at the nucleus, mediating transcriptional regulation and mainly enriching in androgen receptor, C-MYB transcription factor and HIF-2α transcription regulation and other related signaling pathways. MAML1 expression was positively related with the expression of B cell, CD4⁺ T cell and macrophages (P<0.05), but without significant difference with tumor purity, CD8⁺ T cell, neutrophils and dendritic cells (P>0.05). Conclusions MAML1 could be used as a marker of clinical prognosis of patients with GC. The potential molecular mechanism might be associated with its function in transcriptional regulation and changes in tumor microenvironment.

目的 分析抗中性粒细胞胞浆抗体(ANCA)阳性类风湿关节炎(RA)患者的临床及血清学特征。方法 回顾性比较分析2019—2020年本院住院113例核周型抗中性粒细胞胞浆抗体(P-ANCA)阳性及120例P-ANCA阴性RA患者的临床及实验室资料。结果 P-ANCA阳性组的抗环瓜氨酸肽(CCP)抗体为(171.47±130.48)U/mL,阴性组为(130.10±132.7)U/mL,t=2.250,P=0.026。阳性组的抗CCP抗体的阳性率为82/98(83.67%),阴性组为71/110(64.55%),χ²=9.749,P=0.003。阳性组CCP抗体高滴度率63/98(64.29%),阴性组为53/110(48.18%),χ²=5.449,P=0.025。阳性组的RF浓度:(205.14±276.08)U/mL,阴性组RF浓度:(136.94±201.51)U/mL,t=2.159,P=0.032;阳性组的RF阳性率为98/112(87.5%),阴性组的78/120(65.89%),χ²=16.016, P<0.001;阳性组的类风湿因子高浓度率73/112(64.60%),阴性组56/120(46.67%),χ²=8.042, P=0.005。结论 P-ANCA阳性的RA患者的抗体水平相对更高。

Objective To analyze the clinical and serological characteristics of rheumatoid arthritis (RA) patients with positive anti-neutrophil cytoplasmic antibodies (ANCA). Methods The clinical and laboratory data of 113 perinuclear-ANCA (P-ANCA) positive and 120 P-ANCA negative RA patients in our hospital from 2019 to 2020 were retrospectively analyzed. Results The anti-cyclic citrullinated peptide (CCP) antibody of P-ANCA positive group was (171.47±130.48) U/mL, and which in the negative group was (130.10±132.7) U/mL, t=2.250, P=0.026. The positive rate of anti-CCP antibodies in positive group was 83.67% (82/98), and that in the negative group was 64.55% (71/110), χ²=9.749, P=0.003. The high titre rate of CCP antibody in positive group was 64.29% (63/98), and that in the negative group was 53/110 (48.18%),χ²=5.449, P=0.025. The RF concentration of positive group was (205.14±276.08) U/mL, the negative group concentration was (136.94±201.51) U/mL, t=2.159, P=0.032; the RF-positive rate of positive group was 87.5% (98/112), 65.89% (78/120) in the negative group, χ²=16.016, P<0.001; the high concentration rate of rheumatoid factor in positive group was 73/112(64.60%), the negative group 56/120(46.67%), χ²=8.042, P=0.005. Conclusions RA patients with positive P-ANCA had relatively higher antibody levels.

目的 探讨多原发恶性肿瘤(MPMN)的临床特点,提高该类型肿瘤的认识,为临床诊断及治疗提供一定的经验。方法 分析2021年12月广州市第一人民医院呼吸与危重症学科二区收治的1例乳腺、甲状腺及肺三重多原发恶性肿瘤的临床特点及诊治经过,并结合相关文献进行回顾分析。结果 该例首患乳腺导管内癌并予手术切除,9年后再同时患肺癌及甲状腺癌,最终确诊为三重多原发恶性肿瘤。结论 通过对多原发恶性肿瘤的临床特点的分析研究,可一定程度提高临床医生对MPMN的认知以及早期临床鉴别的能力,亦为肿瘤患者早期诊断、早期治疗提供更好的时机,改善患者生活质量。

Objective To explore the clinical characteristics of multiple primary malignant neoplasms (MPMN), to improve the understanding of this type of tumors, and to provide some experience for clinical diagnosis and treatment. Methods The clinical characteristics, diagnosis and treatment of a case with triple MPMN of breast, thyroid and lung treated in the Respiratory and Critical Care Department (Area 2) of Guangzhou First People's Hospital in December 2021 were analyzed retrospectively. Results The breast intraductal carcinoma was the first tumor of that case and had been resected, and 9 years later, lung cancer and thyroid cancer occured at the same time, which were diagnosed as triple MPMN. Conclusions The analysis and study of the clinical characteristics of MPMN can improve the clinicians' cognition and the ability of early clinical differentiation, and provide a better opportunity for early diagnosis and early treatment of tumor patients, and improve their quality of life.

目的 探讨不同年龄段皮罗序列征患儿血气分析的特点、手术后机械通气时间和住院时间。方法 收集新生儿及非新生儿III度皮罗序列征(PRS)患儿各30例,PRS患儿入院后通过桡动脉进行采集血标本进行血气分析,比较2组血标本的 pH 值、PCO₂ 、PO₂ 、HCO^-₃、BE、乳酸、AG、A-aDO₂的特点、手术后机械通气时间及住院时间。结果 新生儿组PCO₂、HCO^-₃、BE、乳酸及A-aDO₂高于非新生儿组,非新生儿组PO₂及AG高于新生儿组。2组pH值、PO₂、AG均在正常范围,机械通气及住院时间与乳酸呈正相关,与年龄呈负相关。结论 不同的年龄阶段,PRS患儿的动脉血气分析的结果不同,高乳酸与低年龄PRS患儿手术后机械通气时间及住院时间长。

Objective To investigate the characteristics of arterial blood gas analysis, time of mechanical ventilation and hospital stay in different age patients with Pirre Robin sequence (PRS). Methods Sixty children with III-grade PRS were divided into two groups according to their age, as neonate group and non-neonate group. The blood samples were collected from radial artery after admission for blood gas analysis, the characteristics of pH value, partial pressure of carbon dioxide (PCO₂), partial pressure of blood oxygen (PO₂), bicarbonate ion (HCO^-₃), base excess (BE), lactic acid (Lac), anion gap (AG) , alveolar artery oxygen pressure difference (A-aDO₂) , postoperative mechanical ventilation time and hospital stay were compared between the two groups. Results The levels of PCO₂, HCO^-₃, BE, Lac and A-aDO₂ in neonate group were higher than those in non-neonate group, and the levels of PO₂ and AG in non-neonate group were higher than those in neonate group. The pH value, PO₂ and AG of the two groups were in the normal range. Post-operative mechanical ventilation time and hospital stay were positively correlated with Lac and negatively correlated with age. Conclusions In different age groups, the results of arterial blood gas analysis in PRS children were different, and the time of mechanical ventilation and hospital stay were longer in higher Lac level and younger patients with PRS.

目的 分析接受永久性膀胱造瘘男性患者相关尿标本病原菌学分布特点及耐药性,进一步为药物防治导管伴随性尿路感染提供科学依据。方法 回顾性分析2019年1月—2021年8月我院收治的368例接受永久性膀胱造瘘男性患者尿标本病原菌分离培养结果,观察其病原菌构成和分布特征,进一步分析相关耐药性。结果 (1)本组接受永久性膀胱造瘘男性患者共368例,尿培养阳性316例,阳性率85.87%(316/368);共分离出病原菌112株,分离率30.43%(112/368),其中革兰阴性菌80株,占71.43%(80/112),以大肠埃希菌、铜绿假单胞菌为主;革兰阳性菌31株,占27.68%(31/112),以表皮葡萄球菌、粪肠球菌为主;真菌1株,占0.89%(1/112)。(2)大肠埃希菌对氨苄西林耐药率66.67%、哌拉西林64.71%、头孢曲松60.78%、头孢他啶60.78%、环丙沙星62.75%,对青霉素耐药率较低,仅为5.88%,对亚胺培南和美罗培南的耐药性为0。铜绿假单胞菌对氨苄西林、头孢噻肟完全耐药,耐药率高达100.00%;对头孢曲松83.33%、哌拉西林72.20%、头孢他啶72.22%;对庆大霉素的耐药率较低,仅为16.67%,对亚胺培南、美罗培南无耐药性。(3)表皮葡萄球菌对氨苄西林耐药性和青霉素的耐药性均为100.00%;对哌拉西林、头孢曲松、头孢噻肟耐药率＞60%;对磺胺甲噁唑／甲氧苄啶的耐药率较低,仅为12.50%,对万古霉素无耐药性。粪肠球菌对庆大霉素完全耐药,耐药率为100.00%;对头孢曲松、环丙沙星、左氧氟沙星、红霉素的耐药率＞60.00%;对头孢他啶的耐药性较低,耐药率仅为25.00%,对青霉素、万古霉素无耐药性。结论 永久性膀胱造瘘患者病原菌主要是大肠埃希菌、铜绿假单胞菌等革兰阴性菌,革兰阳性菌以表皮葡萄球菌为主,对于不同抗菌药物的耐药性差异较大。

目的 统计分析茂名市2016—2021年各种成分血临床供血情况,分析不同成分ABO血型供血特点,总结供血趋势,为今后采供血工作提供参考。方法 通过血液信息管理系统和统计“血库库存监控”中血库预警情况,统计分析茂名市2016—2021年各类成分血临床供应情况。结果 2016—2021年茂名市中心血站临床供血总量1 635 494.5 U,年平均增长率10.74%;红细胞类、血浆类、冷沉淀和浓缩血小板临床供应量年平均增长速度分别为11.58%、8.68%、5.88%、19.41%,各血型占比均为O型>A型>B型>AB型;2018年后机采血小板临床供应量逐年增长;AB型浓缩血小板报废占比最大。结论 2016—2021年茂名市中心血站临床血液供应量逐年增长,O型用血在茂名地区所占比例最大,AB型所占比例最小。在未来采供血工作中,结合临床不同血型成分血使用特征,注意不同血型血液库存,优化血库库存警戒线,防止过多血液过期报废。

Objective To statistically analyze the clinical supply of various blood components in Maoming City from 2016—2021, analyze the characteristics of various ABO blood components supply, and summarize the trend of blood supply as a reference for future blood collection. Methods Using the blood information management system and the early warning situation of the blood bank in “blood bank inventory monitoring”, the clinical supply of various blood components from 2016 to 2021 was statistically analyzed. Results The total supply amount of clinical blood from Maoming Central Blood Bank in 2016-2021 was 1635 494.5 U, with an average annual growth of 10.74%; the percentage of each blood components (red cell, plasma, cryoprecipitate and pooled platelets) was O>A>B>AB, with an average annual growth rate of 11.58%, 8.68%, 5.88% and 19.41%.After 2018, the clinical supply of mechanically collected platelets increased year by year.Scrapped pooled platelets of AB type accounted for the largest proportion. Conclusions Clinical blood supply in Maoming central blood bank was increasing yearly from 2016 to 2021, with the largest proportion of blood type O in Maoming region and the smallest proportion of blood type AB.In the future blood collection and supply, we will pay attention to blood products for different blood types in stock by taking into account the different blood types usage,pay attention to the blood stocks of different blood types, optimize the alarm threshold of blood bank stocks, to prevent overmuch blood from expiring and being scrapped.

目的 分析120例动眼神经麻痹患者的病因及临床特点。方法 收集2019年5月—2021年7月我科收治的120例动眼神经麻痹患者临床资料进行分析,统计所有患者的病因、临床特点、治疗结果。结果 120例患者均急性起病,单眼发病105例(87.50%)、双眼发病15例(12.50%),所有患者均有不同程度的上睑下垂、眼球外下斜视、眼球转动受限、复视,入选患者中年龄构成占比最大的为41~60岁(49例,40.83%);在120例动眼神经麻痹患者中,明确诊断103例(85.83%)、病因诊断未明确17例(14.17%),完全性动眼神经麻痹23例(19.17%)、不完全性动眼神经麻痹97例(80.83%)。病因占比最多的分别是糖尿病18例(15.00%)、动脉瘤16例(13.33%)、脑梗死15例(12.50%);持续治疗3个月后,痊愈者88例(73.33%)、有效者21例(17.50%),无效者11例(9.17%)。结论 动眼神经麻痹的病因以糖尿病、动脉瘤、脑梗死最为常见,临床表现可有不同程度的上睑下垂、眼球外下斜视、眼球转动受限、复视,大多数患者经过积极治疗后可痊愈或好转,在临床中需结合多种诊断技术及原发性疾病进行诊断和治疗。

Objective To analyze the etiology and clinical characteristics of 120 patients with oculomotor nerve paralysis. Methods The clinical data of 120 patients with oculomotor paralysis treated in our department from May 2019 to July 2021 were collected and analyzed, and the etiology, clinical characteristics and treatment results of all patients were summarized. Results All 120 patients had acute onset, 105 cases (87.50%) had monocular onset and 15 cases (12.50%) had binocular onset.All patients had different degrees of ptosis, exophthalmos, hypotropia, limited eye rotation and diplopia.The largest age composition among the selected patients was 41 ~ 60 years old (49 cases, 40.83%).Among 120 patients with oculomotor nerve palsy, 103 cases (85.83%) were clearly diagnosed, 17 cases (14.17%) were not, 23 cases (19.17%) were complete oculomotor nerve palsy and 97 cases (80.83%) were incomplete oculomotor nerve palsy.The most common causes were diabetes mellitus (18 cases, 15%), aneurysms (16 cases, 13.33%), and cerebral infarction (15 cases, 12.50%).After 3 months of continuous treatment, 88 cases (73.33%) were cured, 21 cases (17.50%) were improved and 11 cases (9.17%) had few changes. Conclusions The main causes of oculomotor nerve palsy were diabetes mellitus, aneurysm and cerebral infarction.The clinical manifestations could be varying degrees of ptosis, exophthalmos and strabismus, limited rotation of eyeball and diplopia.Most patients could be cured or improved after treatment.In clinical practice, a variety of diagnostic techniques and primary diseases should be combined to diagnose and treat those patients.