论文部分内容阅读
目的 :探讨外伤性视神经损伤的手术时机与疗效的关系。方法 :经鼻外眶筛蝶窦进路显微视神经管减压术 9例 ;经鼻内窥镜筛蝶窦进路行视神经管减压术 14例 ,辅以大剂量皮质类固醇激素、能量合剂和神经营养药物。结果 :2 3例中有效 13例 ,视力平均提高 0 .2 33,无效 10例 ,有效率为 5 6 .5 %。 13例有效患者 ,其外伤至手术时间平均为 (2 .91± 1.87) d;10例无效患者 ,其外伤至手术时间平均为 (12 .90± 16 .77) d,两者相比较 ,其差异有极显著性意义 (P <0 .0 1)。8例外伤后眼球活动受限的患者 ,其中 7例恢复正常。结论 :外伤性视神经损伤在经过大剂量类固醇激素等治疗 48h无效者 ,应立即进行视神经管减压术 ,手术时机最好在外伤后 7d内进行。
Objective: To investigate the relationship between operative timing and curative effect of traumatic optic nerve injury. Methods: Nine patients underwent microsurgical nerve canal decompression through nasal orbital sieve and sphenoid sinus approach. 14 patients underwent optic nerve canal decompression through nasal endoscope and sphenoid sinus approach, supplemented with high-dose corticosteroid and energy mixture And neurotrophic drugs. Results: Of the 23 cases, 13 were effective, the average visual acuity increased by 0.23, 10 were ineffective, and the effective rate was 56.5%. Among 13 effective patients, the average time from trauma to operation was (2.91 ± 1.87) d. The average time from trauma to operation was (12.90 ± 16.77) days in 10 patients, The difference was significant (P <0.01). Eight patients with limited eye movement after trauma, of which seven returned to normal. CONCLUSION: Traumatic optic nerve injury should be performed immediately after 48 h of treatment with high-dose steroid hormone. Decompression of the optic canal should be performed immediately. The timing of surgery is best performed within 7 days after trauma.