外伤性视神经病变致伤原因及视力预后的多因素分析  

A study on the cause of injury and prognostic factors for visual acuity in patients with traumatic optic neuropathy

作　　者：郑姣[1] 王平[1] 杨庆国[1] 龚晋[1] 简岩[1] 王军令[1] 王玲琳[1] 

机构地区：[1]三峡大学仁和医院眼科,宜昌443001

出　　处：《中国神经精神疾病杂志》2014年第2期71-74,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的分析外伤性视神经病变的致伤原因,探讨视力预后的影响因素。方法回顾性收集2007年1月至2012年12月在三峡大学仁和医院眼科住院的外伤性视神经病变患者104例(108眼)的临床资料,分析患者的致伤原因,采用多因素Logistic回归分析筛选影响外伤性视神经病变预后的危险因素。结果本组病例平均年龄(33.6±12.8)岁,男95例,占91.3%。致伤原因主要以非机动车、机动车事故为主(84例,占80.8%)。绝大多数患者在伤后3d内就诊(81例,占77.9%)。总体疗效有效率为45.4%(49/108),伤后视力为无光感患眼的有效率为29.9%(20/67),伤后视力为光感及以上患眼的有效率为70.7%(29/41)。多因素Logistic回归分析显示,就诊时间≥伤后24h、眶内出血或眶骨骨折、筛窦/蝶窦出血、伤后无光感是外伤性视神经病变视力预后的独立危险因素。结论就诊时间长和病情严重是影响外伤性视神经病变视力预后的独立危险因素,控制好上述危险因素,对外伤性视神经病变的治疗和预后有重要临床意义。Objective To analysis the cause of injury of traumatic optic neuropathy and explore the main factors affecting the prognosis of visual acuity. Methods We retrospectively collected clinical data of 104 cases （108） of traumat- ic optic neuropathy from January 2007 to December 2012 in the Renhe Hospital of Three Gorges University. We then ex- amined the cause of injury and analyzed risk factors for poor prognosis of visual acuity in traumatic optic neuropathy us- ing multivariate Logistic regression analysis. Results The mean age of patients was 33.6 ＋ 12.8 years and 95 cases （91.3%） were males. The injury was mainly caused by non-motor vehicle and motor vehicle accidents （84 cases, 80.8%）. Most of the patients came to the hospital within 3 days after the injury （81 cases, 77.9%）. Overall efficacy rate of treat- ment was 45.4% （49/108）. The effective rate was 29.9% （20/67） for visual acuity without light perception and 70.7% （29/ 41） for visual acuity with light perception, respectively. Logistic regression analysis showed that the time to treatment~〉 24h, orbital hemorrhage or orbital fracture, ethmoid or sphenoid sinus bleeding and no light perception vision were an in- dependent prognostic factors. Conclusion Time to treatment time and severity of injury are the independent risk factors for poor visual prognosis of traumatic optic neuropathy whereas controlling these risk factors has important clinical signifi- cance to the treatment and prognosis of traumatic optic neuropathy.

关 键 词：外伤性视神经病变 致伤原因 预后 危险因素 

分 类 号：R779.1[医药卫生—眼科]