视神经减压术治疗创伤性视神经损伤的手术时机(国内文献分析)  

Opportunity of Optic Nerve Decompression in Treatment of Traumatic Optic Nerve Neuropathy:Review of Domestic Literature

作　　者：金海[1] 侯立军[1] 潘承光[1] 卢亦成[1] 

机构地区：[1]解放军第二军医大学长征医院神经外科,上海市神经外科研究所,上海200003

出　　处：《临床军医杂志》2009年第1期61-63,共3页Clinical Journal of Medical Officers

摘　　要：目的总结不同手术时机对视神经管减压术疗效的影响。方法以关键词"创伤性、视神经损伤、手术时机"检索三大中文数据库,严格按照诊断标准筛查病例,最后收录了16篇国内关于视神经管减压术治疗外伤性视神经损伤的文献报道,通过目前公认的视神经损伤恢复标准判定方法:"无光感、光感、眼前手动、眼前指数、视力表0.04以上",术后与术前视力相比提高1个等级视为有效,分析了这16篇(共670例683眼)文章,讨论选择不同时机行视神经管减压术病例的术后疗效。结果670例683眼中外伤后3d以内手术组,手术有效率77.3%;3～7d手术组,手术有效率65.8%;>7d手术组,手术有效率30%,三组之间相比有统计学意义(P<0.01)。结论外伤性视神经损伤在明确诊断下,如有手术指征并且病人全身条件允许,越早行视神经减压术效果越好。外伤后3d以内手术效果最佳。Objective To summarize the therapeutic effect of optic canal decompression by selection of different operative opportunities. Methods By thoroughly reviewing 16 Chinese references, the clinical data of optic canal decompression of 670 eases （683 eyes） with traumatic optic neuropathy were collected and analyzed retrospectively. Results Among the 683eyes, 225 eyes underwent operation in 3days with a utility ratio of 77.3%, 146 eyes underwent operation in 3 -7 days with a utility ratio of 65.8%, and 51 eyes underwent operation after 7 days with a utility ratio of 30%. There were signitificant differences among these gtoups. Conclusion With difinite diagnosis and operation indication, the traumatic optic neuropathy should undergo optic canal decompression as early as possible. The operation in 3 days makes the best prognosis.

关 键 词：创伤 视神经损伤 减压术 手术时机 

分 类 号：R774.6[医药卫生—眼科]