【摘要】：目的探討經(jīng)額外側(cè)入路視神經(jīng)管減壓術(shù)治療外傷性視神經(jīng)損傷后失明病人的效果。方法回顧性分析13例外傷性視神經(jīng)損傷病人(病眼14只)的臨床資料,術(shù)前病眼視力均為無(wú)光感,均采用經(jīng)額外側(cè)入路視神經(jīng)管減壓術(shù)治療,術(shù)后定期隨診。以視力提升2個(gè)級(jí)別及以上為有效,視力提升1個(gè)級(jí)別為改善,視力一直無(wú)光感為無(wú)效。結(jié)果術(shù)后1周內(nèi)視力恢復(fù)情況:達(dá)眼前指數(shù)3眼,眼前指動(dòng)1眼,光感2眼,無(wú)光感8眼。術(shù)后1個(gè)月視力恢復(fù)情況:達(dá)辨識(shí)字體2眼,眼前指數(shù)4眼,眼前指動(dòng)1眼,光感1眼,無(wú)光感6眼。遠(yuǎn)期視力達(dá)有效7眼,改善1眼,均在損傷后9 d內(nèi)行手術(shù)治療;無(wú)效6眼,在損傷后9 d內(nèi)手術(shù)2眼,超過(guò)9 d行手術(shù)治療4眼。結(jié)論外傷性視神經(jīng)損傷致失明病人保守治療無(wú)改善,應(yīng)盡快手術(shù)治療,經(jīng)額外側(cè)入路視神經(jīng)管減壓術(shù)是有效的治療方法。
[Abstract]:Objective to investigate the effect of transfrontalateral optic canal decompression in the treatment of blindness after traumatic optic nerve injury. Methods the clinical data of 13 patients with traumatic optic nerve injury (14 eyes) were analyzed retrospectively. the visual acuity of the diseased eyes was no light sense before operation. The visual acuity was improved by 2 grades and above, and the visual acuity was improved by 1 grade. Results within 1 week after operation, visual acuity recovered in 3 eyes, finger movement in 1 eye, light perception in 2 eyes and no light perception in 8 eyes. One month after operation, visual acuity recovered in 2 eyes, index in 4 eyes, finger movement in 1 eye, light perception in 1 eye and no light sense in 6 eyes. The long-term visual acuity was effective in 7 eyes and improved in 1 eye, all of which were treated within 9 days after injury, 2 eyes within 9 days after injury and 4 eyes within 9 days after injury. Conclusion there is no improvement in conservative treatment of blindness caused by traumatic optic nerve injury. Surgical treatment should be performed as soon as possible. Decompression of optic canal through additional lateral approach is an effective treatment.
【作者單位】： 安徽醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)外科;
【分類號(hào)】：R779.1

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