外伤性视神经病变26例临床分析

Clinical analysis of 26 cases with traumatic optic neuropathy

目的 探讨外伤性视神经病变的诊断方法及治疗效果。方法 对5年间收治的26例(28只限)视神经损伤患者的临床特点与治疗效果进行总结分析。结果 无光感21只眼有5只眼视力提高，光感以上7只眼均有不同程度提高。6只眼行视神经管减压术，其中2只眼仍无光感，4只眼视力提高。结论 外伤性视神经病变多见于车祸头部外伤后，应尽早用大剂量糖皮质激素和脱水剂及血管扩张剂等治疗，早期视神经管减压术效果好。伤后立即失明者效果差。

Objective To identify approach of diagnosis and effective treatment for traumatic optic neuropathy （TON）. Methods 26 patients （28 eyes） with TON are retrospecty study for clinical features and visual recovery after medical treatment or/and surgical. Results Only 5 of 21cases with no perception had improvement in the patients. All 7 cases with light perception or better had improvement in the patients who was treated. 4 of 6 cases had improvement when optic nerve decompression was adopted. Conclusion TON was usually occurred in patient with craniofacial trauma due to traffic accidents. An active treatment protecol including optic nerve decompression should be carried out as soon as possible in order to get recovery of vision . The visual improvement was poor in the patients with no light perception after trauma.