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目的观察经鼻内镜眶尖-视神经管减压术治疗外伤性视神经病变的手术效果,总结经验。方法回顾性分析2011年5月至2013年5月收治的外伤性视神经病变行经鼻内镜眶尖-视神经管减压术88例(90只眼)患者资料,其中男性85例,女性3例,平均年龄27.5岁;视力完全失明64只眼(手术前视力完全失明组),有残存视力26只眼(有残存视力组),从受伤到手术平均时间7.5 d,均采用经鼻内镜眶尖-视神经管减压术,观察和分析术后视力恢复及术后并发症情况。结果手术前视力完全失明组64只眼,其中视力改善25只眼(39.9%),达到有效视力16只眼(25.0%);有残存视力组26只眼,其中视力改善24只眼(92.3%),达到有效视力22只眼(84.6%)。残存视力组视力恢复明显高于视力完全失明组(P<0.01)。脑脊液漏3例(3.4%),颈内动脉假性动脉瘤2例(2.7%),对症治疗后痊愈出院。结论经鼻内镜眶尖-视神经管减压术是治疗外伤性视神经病变的安全、有效的治疗方法,能够促进视功能恢复。
Objective To observe the effect of endoscopic orbital apical-optic canal decompression in the treatment of traumatic optic neuropathy and to summarize the experience. Methods The data of 88 patients (90 eyes) undergoing endoscopic orbital apical-optic canal decompression of traumatic optic neuropathy admitted from May 2011 to May 2013 were retrospectively analyzed. There were 85 males and 3 females, Average age of 27.5 years old; visual acuity completely blind 64 eyes (preoperative visual acuity completely blind group), 26 eyes with residual vision (residual visual acuity group), from injury to operation average 7.5 d, were adopted endoscopic nasal orbital - Optic tube decompression, visual acuity recovery and postoperative complications were observed and analyzed. Results Sixty-six eyes (25.0%) had visual acuity improvement in 25 eyes (39.9%), 26 eyes in residual visual acuity (24 eyes), 24 eyes (92.3% ), Reaching the effective vision of 22 eyes (84.6%). Visual acuity in residual visual acuity group was significantly higher than that in complete blindness group (P <0.01). Cerebrospinal fluid leakage in 3 cases (3.4%), internal carotid artery pseudoaneurysm in 2 cases (2.7%), cured after symptomatic treatment was discharged. Conclusion Nasal endoscopic orbital apex - optic canal decompression is a safe and effective treatment for traumatic optic neuropathy, which can promote visual function recovery.