视觉诱发电位对外伤性视神经病变患者联合治疗效果的评价作用

发布时间：2018-01-18 06:14

本文关键词：视觉诱发电位对外伤性视神经病变患者联合治疗效果的评价作用　出处：《山东医药》2017年45期 　论文类型：期刊论文

【摘要】：目的探讨视觉诱发电位(VEP)对外伤性视神经病变(TON)患者视神经管减压术+甲基强的松龙疗效的评估价值。方法对120例TON患者进行鼻内镜视神经减压术+甲基强的松龙治疗。有光感患者30例,无光感患者90例。于治疗前,治疗后2、6、12周分别行VEP及视力检查,VEP结果均与自身健眼对比,评估治疗效果,分析治疗前后VEP与疗效的关系。结果经鼻内镜视神经减压术治疗TON患者后2、6、12周,治疗有效率分别为58.33%、62.65%、66.67%。其中术后12周有光感患者疗效高于无光感患者,无光感但VEP有波形患者(70例)视力高于无光感VEP无波形患者(20例)(P均0.05)。治疗前VEP有波形患者100例中视力都有不同程度恢复,而无波形患者20例中仅5例恢复光感。与有光感患者比较,各时间点无光感患者均表现为P2波潜伏期延长值增大,P2波峰值降低(P均0.05)。与有效患者比较,各时间点无效患者表现为P2波潜伏期延长值增大,P2波峰值降低(P均0.05)。不同时间视力与P2波潜伏期延长值均呈正相关(r值分别为0.799、0.835、0.830、0.847,P0.05),与VEP中P2峰值正相关(r值分别为0.563、0.635、0.646、0.635,P均0.05)。结论 VEP检查可评价TON患者视神经管减压术+甲基强的松龙治疗效果。
[Abstract]:Objective to investigate the effect of visual evoked potential (VEP) on traumatic optic neuropathy. Methods 120 patients with TON were treated with methylprednisolone by endoscopic optic decompression, and 30 patients with light sensation were treated with methylprednisolone. The results of VEP and visual acuity examination were compared with those of normal eyes before and after treatment, and the therapeutic effect was evaluated. Results the effective rates of VEP were 58.33% and 62.65%, respectively, 2 weeks after the treatment of TON by endoscopic optic nerve decompression. The curative effect of patients with light sensation at 12 weeks after operation was higher than that of patients without light sensation. Visual acuity of patients without light sensation but with VEP waveform (70 cases) was higher than that without VEP without light perception (P < 0.05). Before treatment, the visual acuity of 100 patients with VEP waveform recovered in varying degrees. But only 5 out of 20 patients with no waveform recovered light sensation. Compared with the patients with light sensation, the patients with no light sensation at each time point showed an increase in the latency of P2 wave. Compared with the effective patients, the patients with invalid P2 wave showed prolonged latency of P2 wave at different time points. The peak value of P2 wave was decreased by 0.05g / L, and the visual acuity was positively correlated with the prolongation of latency of P2 wave (r = 0.799 卤0.835 卤0.830 卤0.847). The positive correlation between P _ (2) and P _ (2) peak value in VEP was 0.563n 0.635U 0.646N 0.635, P _ (0.05), P _ (0.05), P _ (0.05). Conclusion VEP examination can evaluate the effect of methylprednisolone on optic canal decompression in patients with TON.
【作者单位】：河北省眼科医院;
【分类号】：R774.6
【正文快照】： 外伤性视神经病变(TON)是由于钝性或穿透性头部创伤导致的视力下降或丧失[1],大多为视神经间接损伤,占头部闭合性损伤的0.5%~5%[2]。在最初的创伤后,肿胀的视神经管或视神经内的骨头碎片可以压迫视神经,从而导致继发性视网膜神经节细胞损失[3]。随着鼻内镜手术的进展,TON的治

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