内镜下经鼻视神经管减压术对外伤性视神经病变的疗效评价  

Evaluation of therapeutic effect of nasal neuroendoscopic decompression on traumatic optic neuropathy

作　　者：张恒森 陈宾 余彭 鲍跃 李志鹏[1] 王春霞[2] 王义宝[1] 王运杰[1] 王勇[1] ZHANG Hengsen;CHEN Bin;YU Peng;BAO Yue;LI Zhipeng;WANG Chun-xia;WANG Yibao;WANG Yunjie;WANG Yong(Department of neurosurgery,the first hospital of China medical university,Shenyang 110001,China;Department of ophthalmolongy,the fourth affiliated hospital of China medical university,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院神经外科,沈阳110000 [2]中国医科大学附属第四医院眼科,沈阳110000

出　　处：《中国实用眼科杂志》2021年第1期22-26,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察内镜下经鼻视神经管减压术(ETOCD)对治疗外伤性视神经病变(TON)的疗效。方法回顾性分析47例TON患者。按是否接受经鼻视神经管减压术,将患者分为非手术治疗组(14例16只眼)与手术治疗组(33例33只眼),以患者视力级别的提高做为临床疗效判定。结果在TON 47例(49只眼)中,非手术治疗组,有效3只眼,有效率18.8%;手术治疗组,有效25只眼,有效率75.8%,两组有效率存在明显差异(P<0.05)。伤后<72小时手术治疗21只眼,有效16只眼,有效率为76.2%,伤后≥72小时手术治疗12只眼,有效9只眼,有效率为75.0%,两组有效率无明显差异(P>0.05)。结论ETOCD是治疗TON的有效手术方式,且具有微创、侵入性小、术区暴露充分及术野清晰等优势。对于伤后超过72小时且小于两周的患者,手术治疗也具有明显疗效。Objective To observe the effect of endoscopic transnasal optic canal decompression(ETOCD)on the treatment of traumatic optic neuropathy.Methods A retrospective analysis of 47 patients with TON.The patients were divided into Non-surgical treatment group(16 eyes of 14 cases)and surgical treatment group(33 eyes of 33 cases,ETOCD).Results In 47 cases of TON(49 eyes),3 eyes’visual acuity was improved in non-operation(3/16);25 eyes’visual acuity was improved in operation group(8/33);the difference between the two groups was significant(P<0.05).Among the surgical treatment group,16 eyes’visual acuity was improved in 21 eyes(16/21)with the interval time between injury and operation less than 72 hours.9 eyes’visual acuity was improved in 12 eyes(9/12)with the time more than 72 hours after injury,there was no significant difference between the two groups(P>0.05).Conclusions ETOCD has the advantages of minimally invasive,adequate surgical exposure and clear field,and also has a significant effect on patients who have been more than 72 hours after injury and less than two weeks.

关 键 词：鼻内镜 视神经管减压术 外伤性视神经病变 疗效评价 

分 类 号：R65[医药卫生—外科学]