鼻内镜下视神经减压术对外伤性视神经病变疗效评价及预后因素分析

发布时间：2018-10-05 12:38

【摘要】：目的探讨鼻内镜下视神经减压术对外伤性视神经病变(TON)的疗效及影响预后的因素。方法回顾性分析2010年-2015年53例TON患者。按是否接受鼻内镜下视神经减压手术,将患者分为手术组及非手术组,应用χ2检验、成组t检验、多元线性回归分析统计学方法分析影响预后的可能因素。结果在TON 53例(55眼)中,其中治疗前无光感31眼:手术治疗16眼,有效8眼,有效率50.0%(8/16);保守治疗15眼,有效3眼,有效率20.0%(3/15)。治疗前有光感24眼:手术治疗14眼,有效11眼,有效率78.6%(11/14);保守治疗10眼,有效3眼,有效率30.0%(3/10)。手术治疗30眼,无1例出现并发症,总有效率63.3%(19/30)。年龄、侧别、性别、治疗前有无光感、有无视神经管骨折及有无眶尖骨折与预后无相关性(P0.05);外伤到治疗时间是否超过3天及治疗方式与预后有明显相关性(P0.05)。结论鼻内镜下视神经减压术是TON的有效治疗方法。TON在3 d内进行治疗,有利于视力的恢复。
[Abstract]:Objective to investigate the effect of endoscopic optic nerve decompression on traumatic optic neuropathy (TON) and its prognostic factors. Methods 53 patients with TON from 2010 to 2015 were retrospectively analyzed. The patients were divided into operative group and non-operative group according to whether the optic nerve decompression was performed under nasal endoscope. The possible factors affecting the prognosis were analyzed by 蠂 2 test, t test and multivariate linear regression analysis. Results among 53 cases (55 eyes) of TON, 31 eyes had no light sensation before treatment: 16 eyes were operated, 8 eyes were effective, the effective rate was 50.0% (8 / 16), and conservative treatment was effective in 15 eyes (3 eyes), the effective rate was 20.0% (3 / 15). There was light sensation in 24 eyes before treatment: surgical treatment in 14 eyes, effective in 11 eyes, effective rate in 78.6% (11 / 14), conservative treatment in 10 eyes, effective in 3 eyes, effective rate in 30.0% (3 / 10). There was no complication in 30 eyes. The total effective rate was 63.3% (19 / 30). Age, side, sex, whether there was light before treatment, there was no correlation between the prognosis and neural tube fracture and orbital apex fracture (P0.05); whether the treatment time from trauma to treatment was more than 3 days and the treatment method was significantly correlated with the prognosis (P0.05). Conclusion Endoscopic optic nerve decompression is an effective treatment for TON. Ton is effective in the recovery of visual acuity within 3 days.
【作者单位】：温州医科大学附属第二医院耳鼻咽喉科;
【分类号】：R779.6

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