鼻内镜经蝶窦视神经减压术治疗视神经损伤临床分析

Clinical Analysis of Endoscopic Transsphenoidal Optic Nerve Decompression for Optic Nerve Injury

目的分析鼻内镜经蝶窦视神经减压术治疗视神经损伤临床效果。方法回顾性分析2018年1月—2019年1月期间在该院进行治疗的25例视神经损伤患者的临床资料,均采取鼻内镜经蝶窦视神经减压术治疗,分析手术治疗效果、手术用时以及患者症状消失时间、住院时间、并发症发生率。结果治疗后,23例(92.00%)患者视力有明显提升,8例光感患者中7例(87.50%)视力提高,4例无光感患者有3例(75.00%)视力提高,5例手动、8例数指患者视力均全部提高,最高可达0.12。伤后7 d内手术的8例患者视力全部提高,伤后8~14 d手术的6例患者视力全部提高,伤后15~30 d手术的7例患者有6例视力提高,伤后30 d以上手术的4例患者有3例视力提高;治疗前患者的视力水平为(0.09±0.07),治疗后其视力水平为(0.13±0.04),治疗后的视力水平有显著升高,差异有统计学意义(t=2.48,P<0.05);术后随访记录,并发症发生率为8.00%。结论鼻内镜经蝶窦视神经减压术治疗视神经损伤的效果显著,其对患者创伤小,术后并发症少,具有较好的安全性。

Objective To analyze the clinical effect of nasal endoscopic transsphenoidal optic nerve decompression for optic nerve injury.Methods The clinical data of 25 patients with optic nerve injury who were treated in the hospital from January2018 to January 2019 were retrospectively analyzed.All of them were treated with endoscopic transsphenoidal optic nerve decompression,and analyzed the effect of surgical treatment and the operation time and the time of disappearance of symptoms,length of hospitalization,and incidence of complications.Results After treatment,the visual acuity of 23 patients(92.00%)improved significantly,7 of the 8 light-sensitive patients(87.50%)improved visual acuity,3 patients(75.00%)of4 light-sensitive patients improved visual acuity,and 5 manual patients,8 cases of number finger patients all improved vision,up to 0.12.All 8 patients undergoing surgery within 7 days of injury improved their vision,6 patients undergoing surgery 8-14 days after injury all improved their vision,7 patients undergoing 15-30 surgery after injury had 6 improved vision,and 4 patients undergoing surgery more than 30 days after injury with the visual acuity of 3 cases of patients improved;the visual acuity level of the patients before treatment was(0.09±0.07),and the visual acuity level after treatment was(0.13±0.04),and the visual acuity level after treatment was significantly increased,and the difference was statistically significant(t=2.48,P<0.05);Postoperative follow-up records,the complication rate was 8.00%.Conclusion The effect of endoscopic transsphenoidal optic nerve decompression in the treatment of optic nerve injury is significant.It has less trauma to patients,fewer postoperative complications and good safety.