外伤性视神经病变致伤原因及视力预后的多因素分析

发布时间：2018-08-30 17:02

【摘要】：目的分析外伤性视神经病变的致伤原因,探讨视力预后的影响因素。方法回顾性收集2007年1月至2012年12月在三峡大学仁和医院眼科住院的外伤性视神经病变患者104例(108眼)的临床资料,分析患者的致伤原因,采用多因素Logistic回归分析筛选影响外伤性视神经病变预后的危险因素。结果本组病例平均年龄(33.6±12.8)岁,男95例,占91.3%。致伤原因主要以非机动车、机动车事故为主(84例,占80.8%)。绝大多数患者在伤后3d内就诊(81例,占77.9%)。总体疗效有效率为45.4%(49/108),伤后视力为无光感患眼的有效率为29.9%(20/67),伤后视力为光感及以上患眼的有效率为70.7%(29/41)。多因素Logistic回归分析显示,就诊时间≥伤后24h、眶内出血或眶骨骨折、筛窦/蝶窦出血、伤后无光感是外伤性视神经病变视力预后的独立危险因素。结论就诊时间长和病情严重是影响外伤性视神经病变视力预后的独立危险因素,控制好上述危险因素,对外伤性视神经病变的治疗和预后有重要临床意义。
[Abstract]:Objective to analyze the causes of traumatic optic neuropathy and explore the influencing factors of visual prognosis. Methods the clinical data of 104 cases (108 eyes) of traumatic optic neuropathy in Renhe Hospital of three Gorges University from January 2007 to December 2012 were retrospectively collected and the causes of injury were analyzed. Multivariate Logistic regression analysis was used to screen the prognostic factors of traumatic optic neuropathy. Results the average age of the patients was (33.6 卤12.8) years, 95 males (91.3%). The main causes of injury were non-motor vehicles and motor vehicle accidents (84 cases, 80.8%). Most of the patients were treated within 3 days after injury (81 cases, 77.9%). The overall effective rate was 45.4% (49 / 108), the effective rate of visual acuity was 29.9% (20 / 67), the effective rate was 70.7% (29 / 41). Multivariate Logistic regression analysis showed that intraorbital hemorrhage or orbital bone fracture, ethmoid sinus / sphenoid sinus hemorrhage, and no light sensation after trauma were independent risk factors for visual prognosis of traumatic optic neuropathy. Conclusion long visit time and severe condition are independent risk factors for visual prognosis of traumatic optic neuropathy. It is important for the treatment and prognosis of traumatic optic neuropathy to control the above risk factors.
【作者单位】：三峡大学仁和医院眼科;
【分类号】：R779.1

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