外伤性重度视神经损伤的治疗

Treatment of Traumatic Severe Optic Neuropathy

目的 分析与总结外伤性重度视神经损伤的临床特点与治疗经验。方法 对5年间收治的9例外伤性重度视神经损伤患者的临床特点与治疗效果进行总结,并复习近期相关文献的病例52例。结果 对于外伤性视神经重度损伤,尽管伤后视力丧失,经积极治疗,包括激素应用和视神经减压术,仍有约32％病例的视力可能得到良好恢复。结论 外伤性重度视神经损伤多见于车祸头部外伤后,应尽早积极治疗,以争取视力恢复。

Objective To analyze the clinical features and summarize the treatment outcome of patients with traumatic severe optic neuropathy (TSON). Methods Data of nine cases of TSON, who had been treated in our hospital from July 1994 to July 2000, were analyzed. The literature related with 52 cases with TSON were also reviewed. Result The vision in about 32% of the patients with complete visual loss immediately after trauma could be improved when rational treatment protocol including the use of megadose of corticosteroids and optic nerve decompression was adopted. Conclusions TSON was usually occured in patients with craniofacial trauma due to traffic accidents. An active treatment protocol including optic nerve decompression should be carried out as soon as possible in order to get recovery of vision.