无光感的创伤性视神经损伤患者行内镜视神经管减压的临床价值

Clinical value of endoscopic optic nerve decompression in posttraumatic optic neuropathy patients with no fight preception

目的探讨术前无光感的创伤性视神经损伤患者经内镜行视神经管减压的临床价值。方法应用Messerklinger技术对13例术前无光感的创伤性视神经损伤患者经内镜行视神经管减压术，并对其临床资料进行回顾性分析。结果13例随访3—12个月，7例视力有不同程度恢复，总有效率54％（7／13）；5例无效，失访1例。按受伤后视力丧失至手术时间分为3—7d组，8—14d组，15—21d组和21d以上组，以有效和无效划分比较各组手术效果，各组间效果差异无统计学意义（P〉0．05）。结论术前无光感的创伤性视神经损伤患者行内镜减压可能有效，术前无光感不应成为该手术的禁忌证。

Objective To investigate the clinical value of endoscopic optic nerve decompression in traumatic optic neuropathy patients with no light perception （ NLP）. Methods 13 NLP patients with traumatic optic neuropathy were performed endoscopic decompression of optic nerves basing on the Messerklinger technique and the clinical data were retrospective analyzed. Results Seven of 13 patients with NLP improved at least one grade after three to twelve months follow - up period and the total effective ratio was 54% （7/13）. Six patients showed no change and one patient was lost during follow -up. Based on the duration from loss of vision to operation after trauma, all 13 patients were divided into 3 -7 d group, 8 - 14 d group, 15 -21 d group and above 21 d group. In the analysis of the data of different groups, there was no difference in effect among groups （ P 〉 0. 05 ）. Conclusion Potential benefit could be achieved from endoscopic decompression of optic nerve even for traumatic optic neuropathy patients with no light perception.