不同方式治疗外伤性视神经病变疗效分析  

Therapeutic efficacy of traumatic optic neuropathy treated with different protocal.

作　　者：李珍[1] 杜玉敏[1] 郭华[1] 张海燕 

机构地区：[1]青岛解放军第401医院眼科,266071 [2]青岛基地门诊部

出　　处：《眼外伤职业眼病杂志》2001年第4期396-397,共2页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的　评价大剂量糖皮质激素、视神经减压术和一般药物对外伤性视神经病变的治疗作用。方法　外伤性视神经病变 2 1例 2 3眼 ,10眼应用大剂量糖皮质激素治疗 ,5眼行经眶筛进路视神经减压术 ;8眼采用一般药物治疗。结果　最终有效率皮质激素组 (80 % )、手术组 (10 0 % )和一般治疗组 (6 2 5 % )间差异无显著性意义。但近期有效率皮质激素组 (80 % )和手术组(80 % )均高于一般治疗组 (2 5 % )。最终脱残率 (视力≥ 0 3)皮质激素组 (40 % )和手术组 (40 % )也优于一般治疗组 (0 )。结论　大剂量糖皮质激素和视神经减压术均为外伤性视神经病变早期有价值的治疗措施 。Objective To evaluate the visual outcome of traumatic optic neuropathy treated with megadose corticosteroids,optic canal decompression surgery or conventional treatment.Methods 21 patients (23 eyes) with traumatic optic neuropathy were categorized as being in one of three treatment groups:megadose corticosteroids (10 eyes),optic canal decompression surgery by bital ethmoidal sinus rout (5 eyes),or conventional treatment (8 eyes).Results In total cases,visual acuity inproved in 80% of the corticosteroids group,100% of the surgery group,and 62.5% of the conventional treatment group.There were no significant differences between any of the treatment groups.But the short term (within 3 days)effective rate were 80% in the corticosteroids group,80% in surgery group and 25% in conventional treatment group.The final visual acuity increases significantly (≥0.3) in 40% of the corticosteroids group,40% of the surgery group and zero of the conventional group.The effective rate in eyes with light perception was significantly higher than those with no light perception ( P <0.001).The effective rate in pateints received treatment within 3 days was significantly higher than those received treatment after 3 days ( P <0.05).Conclusions Megadose corticosteroids and optic canal decompression may be benefit to traumatic optic neuropathy.The visual acuity outcomes were better than conventional treatment.

关 键 词：视神经损伤 肾上腺皮质激素 视神经管 视神经减压术 

分 类 号：R774.6[医药卫生—眼科]