Chen M, Jiang Y, Wen J F, Li N, Qiu J, Zhang N K, Ju J B
Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China.
Operating Room, the Affiliated Hospital of Qingdao University, Qingdao 266003, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Sep 7;52(9):659-663. doi: 10.3760/cma.j.issn.1673-0860.2017.09.005.
To analyze the clinical features and the pathogenetic law of traumatic optic neuropathy through epidemiologic study. 265 cases (275 eyes) with TON treated in Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University from April 1999 to August 2015 were retrospectively analyzed. Multiple regression analyses were used to evaluate potential prognostic factors on visual acuity. TON occured mostly in young (194/265, 73.21%) man (235/265, 88.68%), the majority of patients came from villages and towns (209/265, 78.87%). Traffic accident (197/265, 74.34%) remained the main etiology, with strike (36/265, 13.58%) and fall (17/265, 6.42%) as the common etiology. Most patients had head injuries. The effective rate of vision improvement was 53.45%(147/275). Multiple regression analyses identified that initial visual acuity with light perception or better vision, optic canal fracture and orbital wall fracture were visual acuity key factors of TON (χ(2) value was 24.674, 19.755, 9.175, respectively, all <0.01), initial visual acuity with light perception or better vision was the protective factor on visual acuity recovery (=5.008, <0.001), the presence of optic canal fracture and orbital wall fracture were the risk factors on visual acuity recovery ( value was 0.110, 0.329, respectively, all <0.01). Ton occurs mostly in young man because of traffic accident. Visual impairment of TON is severe. The suitable preventive measures should be carried out according to its epidemiological features.
通过流行病学研究分析外伤性视神经病变的临床特征及发病规律。回顾性分析1999年4月至2015年8月在青岛大学附属医院耳鼻咽喉头颈外科治疗的265例(275眼)外伤性视神经病变患者。采用多元回归分析评估视力的潜在预后因素。外伤性视神经病变多见于青年男性(194/265,73.21%),男性居多(235/265,88.68%),大多数患者来自乡镇(209/265,78.87%)。交通事故(197/265,74.34%)仍是主要病因,其次为打击伤(36/265,13.58%)和坠落伤(17/265,6.42%)。多数患者伴有头部外伤。视力改善有效率为53.45%(147/275)。多元回归分析确定,初始视力为光感或更好视力、视神经管骨折和眶壁骨折是外伤性视神经病变视力的关键因素(χ²值分别为24.674、19.755、9.175,均<0.01),初始视力为光感或更好视力是视力恢复的保护因素(β=5.008,<0.001),视神经管骨折和眶壁骨折的存在是视力恢复的危险因素(β值分别为0.110和0.329,均<0.01)。外伤性视神经病变多见于青年男性,因交通事故所致。外伤性视神经病变视力损害严重。应根据其流行病学特征采取适当的预防措施。