外伤性视神经病变不同治疗方法的临床研究

Clinical research of different curative methods in traumatic optic neuropathy

目的比较外伤性视神经病变(TON)患者经鼻内镜下视神经管减压术(EOND)与单纯药物治疗的临床疗效。方法回顾性研究1999年8月～2008年1月TON患者临床资料。88例患者被分为EOND组(42例)和单纯药物治疗组(46例),对比两者之间疗效差异;根据受伤至手术的间隔时间不同,将手术组分为伤后7d以内手术组与7d以后手术组,比较疗效差异。结果①药物组与手术组比较,两者之间差异均有统计学意义(P=0.040,P=0.030),手术疗效优于药物治疗。②接受手术患者中,伤后7d以内手术组与7d以后手术组比较,两者之间差异有统计学意义(P=0.029),7d以内手术组优于7d以后手术组。结论联合手术治疗的疗效优于单纯药物治疗;手术时间以伤后7d以内为佳。

[Objective] This paper compares the curative effect of endoscopic optic nerve decompression （EOND） and simple medical treatment and analyze risk factors in traumatic optic neuropathy （TON）. [Methods] Retrospectively reviewed patients with TON from August 1999 to January 2008. The 88 patients （88 eyes） with TON are divided into two groups： EOND （42 eyes） and drug （46 eyes） and curative effects of the two groups are compared. The best operation time can be sought, based on the analysis of operations within or after 7 days since injures. [Results] There is statistic difference （P =0.044, （P =0.030） between the surgical group and the drug group. The curative effect of operation is much better. According to the operation periods, there is difference （（P =0.029） between injured patients operated within 7 days and after 7 days. It shows --the sooner, the better. [ Conclusion] Therapeutic effect of surgical treatment is better than that of medication therapy. Therapeutic effect of patients in operation within 7 days is better than that after 7 days.