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[外伤性视神经病变的临床治疗]

[The clinic treatment of traumatic optic neuropathy].

作者信息

Chen X, Li Y, Wang M, Zhou Q, Ye F

机构信息

Department of Otorhinolaryngology, Anhui Province Hospital, Hefei 230001.

出版信息

Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2001 Aug;15(8):350-1, 353.

Abstract

OBJECTIVE

To observe the visual outcome of traumatic optic neuropathy treated with optic canal decompression surgery and medication.

METHOD

15 patients, suffering from traumatic optic neuropathy, had received medication and optic canal decompression surgery through the approach of ethmoid and sphenoid sinus. The vision acuity was divided into 5 grades: no light perception, light perception, finger movement, counting fingers, vision > or = 0.1, the vision acuity improvements reaching 2 grades or more were determined as effective. All patients were followed up for intervals of 1 month and 6 months.

RESULT

The total efficient rate is 57.4%, no intraoperative or postoperative complications were encountered. Being followed up 6 months, 2 cases, who underwent respectively the operation 8, 11 days after trauma, felt no light perception.

CONCLUSION

The approach through ethmoid and sphenoid sinus have the merits such as safety, less damage and larger operative field. Timely medication, megacorticosteroid therapy mainly, may play a good role in alleviating optic nerve edema and restoring its function. Comprehensive therapy may be an ideal treatment to traumatic optic neuropathy.

摘要

目的

观察经视神经管减压术联合药物治疗外伤性视神经病变的视力恢复情况。

方法

15例外伤性视神经病变患者,采用经筛窦和蝶窦入路行视神经管减压术并联合药物治疗。视力分为无光感、光感、手动、数指、视力≥0.1共5级,视力提高2级及以上判定为有效。所有患者分别于术后1个月、6个月进行随访。

结果

总有效率为57.4%,术中及术后均未出现并发症。随访6个月时,2例分别于伤后8天、11天接受手术的患者仍无光感。

结论

经筛窦和蝶窦入路具有安全、损伤小、术野大等优点。及时用药,以大剂量糖皮质激素治疗为主,对视神经水肿的减轻及功能恢复可能起到较好作用。综合治疗可能是外伤性视神经病变的理想治疗方法。

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