颅脑外伤合并视神经损伤的临床研究

A clinical study of traumatic brain injury with optic nerve damage

目的探讨颅脑外伤合并视神经损伤的病因、诊疗方案及影响预后的相关因素分析。方法回顾性分析我院124例颅脑外伤合并视神经损伤的临床病例资料,总结其诊治方法并通过单因素分析(χ2)观察影响预后相关因素。结果124例患者经治疗后总有效率为70.31%。手术治疗有效率为60%,药物治疗有效率为71.56%。意识障碍、视神经管骨折与预后无相关性(P>0.05)。光感、治疗时间及VEP波形与视力恢复情况明显相关(P<0.05)。结论视神经损伤治疗疗效较差,但早期诊断和治疗后仍能取得良好效果,目前仍以药物治疗为主,对有手术指证的应早期行手术治疗,以提高患者生存质量。

Objective To investigate the causes,diagnosis and treatment,and prognostic factors for traumatic brain injury with optic nerve damage. Methods A retrospective analysis was performed on the clinical data of 124 cases of traumatic brain injury with optic nerve damage in our hospital. The methods for diagnosis and treatment were summarized. The prognostic factors were identified by univariate analysis（ Chi-square test）. Results In the 124 patients,the overall response rate was 70. 31%; 60% of all patients showed a response to surgical treatment,and 71. 56% showed a response to drug therapy. Unconsciousness and optic canal fracture were not related to prognosis（ P〉0. 05）. Light sensation,treatment time,and VEP waveforms were significantly associated with vision recovery（ P〈0. 05）. Conclusions The treatment of traumatic brain injury with optic nerve damage has low effectiveness,but early diagnosis and treatment can lead to good results. At present,drug therapy is still the main treatment. Surgical treatment should be given to patients with surgical indications early to improve their quality of life.