外伤性视神经病变预后相关因素分析

Analysis of relevant factors affecting prognosis of traumatic optic neuropathy

目的 评价影响外伤性视神经病变预后的相关因素。 方法 回顾分析外伤性视神经病变6 9例的临床资料 ,以伤后 3个月随访视力为最终结果 ,通过多因素分析筛选出影响外伤性视神经病变预后的因素。 结果 6 9例中 3个月以上随访视力无光感者 32例 ,占 4 6 .4 % ;视力进步者 33例 ,占 4 7.8%。伤后视力无光感比有光感以上视力 (P=0 .0 0 31)、伤后有昏迷比伤后无昏迷 (P=0 .0 2 6 2 )、入院前未行常规糖皮质激素治疗比入院前常规应用糖皮质激素治疗 (P=0 .0 184 )、视觉诱发电位 (visual evoked potential,VEP)检查熄灭比 VEP非熄灭者 (P=0 .0 0 0 1)最终视力恢复的危险度增加。 结论 伤后无光感、昏迷、入院前未常规糖皮质激素治疗是影响外伤性视神经病变预后的危险因素 ,VEP检查是评价预后的有效指标。

Objective To evaluate the relevant factors affecting prognosis of traumatic optic neuropathy. Methods Sixty nine patients with traumatic optic neuropathy were enrolled. Multiple variable analysis was done to filter the risk factors to prognosis in traumatic optic neuropathy. Results At 3 months or more of follow up,no light perception was found in 32 cases (46.4%); visual acuity were increased by ≥1 lines in 33 cases (47 8%). The outcome of visual acuity was poorer in patients with the following conditions:no light perception after trauma ( P =0.0031), loss of consciousness ( P =0.0262), no pretreated common dosage corticosteroids ( P =0.0184), and absence of VEP ( P =0.0001). Conclusion The initial visual acuity of no light perception, loss of consciousness, and no pretreated common dosage corticosteroids were the risk factors to prognosis in traumatic optic neuropathy,and result of VEP was an effective prognosis indicator in traumatic optic neuropathy.