鼻内镜下视神经减压手术疗效及影响因素分析  

Analysis of the effect and related factors of endoscopic optic nerve decompression for severe traumatic optic neuropathy

作　　者：魏明辉[1,2] 卢永田 向登[1,2] 董洪松 林峰[1,2] 何贵华 

机构地区：[1]深圳市第二人民医院 [2]深圳大学医学院第一附属医院耳鼻咽喉科,广东深圳518035

出　　处：《中国耳鼻咽喉头颈外科》2013年第6期311-313,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的对创伤性视神经病进行鼻内镜下视神经减压术并观察其疗效及影响因素。方法对我院2003年12月～2012年12月22例创伤性视神经病患者在全麻下行鼻内镜下视神经减压术。结果 22例视神经损伤患者中,术后视力改善者8例,总有效率为36.4%,其中外伤后即出现视力丧失者16例中3例有效,外伤后视力逐渐下降者6例中5例有效;外伤后完全失明时间是预后影响因素,术中是否行鞘膜切开、外伤后进行视神经减压术的时间对疗效无显著性影响。结论创伤性视神经病是鼻内镜视神经减压的手术适应证。外伤后急剧视力下降者行视神经减压术疗效不佳;外伤后视力逐渐下降者,即使过了最佳手术治疗时期仍应积极进行手术。OBJECTIVE To observe the effect of transnasal endoscopic optic nerve decompression on patients with traumatic optic neuropathy and analyze the related influencing factors of the efficacy. METHODS Twenty two patients with traumatic optic neuropathy were treated with endoscopic optic nerve decompression under general anesthesia. RESULTS The postoperative visual acuity was improved in 8 patients and total effective rate was 36.4%. Only 3 of the 16 patients with instant visual loss after injury had visual improvement, but 5 of 6 patients with gradual visual loss had visual improvement. The instant visual loss was an effective prognosis factor of endoscopic optic nerve decompression. The optic nerve sheath incision and intervals between injury and operation had no apparent effect on the efficacy of the operation. CONCLUSION Traumatic optic neuropathy is the indication of endoscopic optic nerve decompression. The effect of the operation for the patients with instant visual loss after injury is not as good as those with gradual visual loss. Active operation should be done in the patients with gradual visual loss even they miss the best operation opportunity.

关 键 词：视神经损伤 减压术 外科 内窥镜检查 

分 类 号：R779.6[医药卫生—眼科]