额外侧入路视神经管减压术在外伤性失明病人中的应用

发布时间：2019-06-22 17:41

【摘要】：目的探讨经额外侧入路视神经管减压术治疗外伤性视神经损伤后失明病人的效果。方法回顾性分析13例外伤性视神经损伤病人(病眼14只)的临床资料,术前病眼视力均为无光感,均采用经额外侧入路视神经管减压术治疗,术后定期随诊。以视力提升2个级别及以上为有效,视力提升1个级别为改善,视力一直无光感为无效。结果术后1周内视力恢复情况:达眼前指数3眼,眼前指动1眼,光感2眼,无光感8眼。术后1个月视力恢复情况:达辨识字体2眼,眼前指数4眼,眼前指动1眼,光感1眼,无光感6眼。远期视力达有效7眼,改善1眼,均在损伤后9 d内行手术治疗;无效6眼,在损伤后9 d内手术2眼,超过9 d行手术治疗4眼。结论外伤性视神经损伤致失明病人保守治疗无改善,应尽快手术治疗,经额外侧入路视神经管减压术是有效的治疗方法。
[Abstract]:Objective to investigate the effect of transfrontalateral optic canal decompression in the treatment of blindness after traumatic optic nerve injury. Methods the clinical data of 13 patients with traumatic optic nerve injury (14 eyes) were analyzed retrospectively. the visual acuity of the diseased eyes was no light sense before operation. The visual acuity was improved by 2 grades and above, and the visual acuity was improved by 1 grade. Results within 1 week after operation, visual acuity recovered in 3 eyes, finger movement in 1 eye, light perception in 2 eyes and no light perception in 8 eyes. One month after operation, visual acuity recovered in 2 eyes, index in 4 eyes, finger movement in 1 eye, light perception in 1 eye and no light sense in 6 eyes. The long-term visual acuity was effective in 7 eyes and improved in 1 eye, all of which were treated within 9 days after injury, 2 eyes within 9 days after injury and 4 eyes within 9 days after injury. Conclusion there is no improvement in conservative treatment of blindness caused by traumatic optic nerve injury. Surgical treatment should be performed as soon as possible. Decompression of optic canal through additional lateral approach is an effective treatment.
【作者单位】：安徽医科大学第一附属医院神经外科;
【分类号】：R779.1

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