外伤性视神经病变的治疗中用和不用糖皮质激素效果比较  

Comparison of the effect of treatment with or without glucocorticoid for traumatic optic neuropathy

作　　者：诸震波[1] 丁宁[1] 朱捷[1] 

机构地区：[1]首都医科大学附属北京同仁医院急诊科,北京100730

出　　处：《中华眼外伤职业眼病杂志》2017年第5期325-328,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的比较糖皮质激素与非糖皮质激素对外伤性视神经病变（TON）的治疗效果。方法收集2013年5月至2016年8月的外伤性视神经病变316例（316只眼），按照随机对照研究方法分为临床试验组（A组，187例）和对照组（B组，129例），分别给予甲泼尼龙治疗（A组）和非糖皮质激素治疗（B组），对比两组的治疗效果。结果A组总体治疗有效率34．8％，B组总体治疗有效率33．3％，两组间治疗总体效果差异无统计学意义（X2=0．069，P=0．793）。针对不同病情分别进行两组有效率对比：伴视神经管骨折者（X^2=0．077，P=0．782），无光感者（X^2=0．073，P=0．787），伴视神经管骨折合并无光感者（X^2=0．030，P=0．863），两组组间的有效率差异均无统计学意义；两组组内不同病情者之间有效率差异也无统计学意义。结论甲泼尼龙治疗与非糖皮质激素治疗在外伤性视神经病变不同病情下的治疗效果差异无统计学意义。Objective To compare the therapeutic effect between glucocorticoid and non- glucocorticoid treatment for traumatic optic neuropathy （TON）. Methods Total of 316 eyes of 316 cases with TON who were treated in Beijing Tongren Hospital from May 2013 to August 2016, were divided into clinical trial group （group A, 187 cases） and control group （group B, 129 cases） randomly. Group A received methylprednisolone treatment and group B without glucocorticoid treatment. The therapeutic effect was observed and compared. Results The total effective rate in group A was 34.8% , in group B was 33.3%, the difference was not statistically significant between the two groups（x2 = 0. 069,P =0. 793 ）. The efficacy between the two groups was compared under different conditions： the difference in optic canal fracture（x^2 0. 077,P =0.782） no light . 2 =0. 073,P 787）, optic = , percepuon（x =0. canal fracture with no light percepuon＇ （X^2 = 0. 030, P = 0. 863 ）, all were not statistically significant between the two groups. Conclusion Methylprednisolone and non-glucocorticoid treatment in the treatment of traumatic optic neuropathy under different conditions there is no statistically significant difference.

关 键 词：视神经病变 外伤性 甲泼尼龙 无光感 视神经管骨折 

分 类 号：R779.1[医药卫生—眼科]