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[鼻内镜下视神经减压术治疗外伤性视神经病变212例分析]

[A 212 cases analysis of treatment for traumatic optic neuropathy by nasal endoscopic opticnerve decompression].

作者信息

Chen M, Jiang Y, Pang W H, Li N, Niu Y Z, Zhao H

机构信息

Department of Otolaryngology, the Affiliated Hospital of Qingdao University, Qingdao, 266003, China.

Department of Pathology, the Affiliated Hospital of Qingdao University.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Sep 20;31(18):1411-1414. doi: 10.13201/j.issn.1001-1781.2017.18.008.

Abstract

To explore the clinical features and therapeutic efficacy of nasal endoscopic optic nerve decompression for traumatic optic neuropathy (TON)treatment.Two hundred and twelve cases (217 eyes) with TON were retrospectively analyzed in our study, who were treated with nasal endoscopic optic nerve decompression in our institution from 1999 to 2016. χ ² -test was used to explore the potential prognostic factors on visual acuity.All patients were followed up from 6 months to 2 years postoperatively, and the effective rate was 54.38%(118/217).In the 166 eyes with no light perception (NLP), the effective rate was 46.39% (77/166), while in the 51 eyes with light perception (LP), the effective rate was 80.39% (41/51).The therapeutic efficacy of patients with LP or above LP was better than that of NLP, and the difference was statistically significant(χ ²=18.186, < 0.01).Moreover, the therapeutic efficacy of patients without an optic canal fracture was better than that with an optic canal fracture,and the difference had statistical significance (χ ²=10.096, <0.01).The efficacy of nasal endoscopic optic nerve decompression on TON was positive, and even for the patients with NLP or a long history also should have a try.

摘要

探讨鼻内镜下视神经减压术治疗外伤性视神经病变(TON)的临床特点及疗效。回顾性分析我院1999年至2016年采用鼻内镜下视神经减压术治疗的212例(217眼)TON患者。采用χ²检验探讨影响视力预后的潜在因素。所有患者术后随访6个月至2年,有效率为54.38%(118/217)。无光感(NLP)的166眼中,有效率为46.39%(77/166);有光感(LP)的51眼中,有效率为80.39%(41/51)。LP及以上患者的治疗效果优于NLP患者,差异有统计学意义(χ²=18.186,P<0.01)。此外,无视神经管骨折患者的治疗效果优于有视神经管骨折患者,差异有统计学意义(χ²=10.096,P<0.01)。鼻内镜下视神经减压术治疗TON疗效肯定,即使是NLP或病程较长的患者也应尝试。

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