目的 观察内镜下经鼻视神经管减压术（ETOCD）对治疗外伤性视神经病变（TON）的疗效。 方法 回顾性分析47例TON患者。按是否接受经鼻视神经管减压术，将患者分为非手术治疗组（14例16只眼）与手术治疗组（33例33只眼），以患者视力级别的提高做为临床疗效判定。 结果 在TON 47例（49只眼）中，非手术治疗组，有效3只眼，有效率18.8%；手术治疗组，有效25只眼，有效率75.8%，两组有效率存在明显差异（P <0.05）。伤后<72小时手术治疗21只眼，有效16只眼，有效率为76.2%，伤后≥72小时手术治疗12只眼，有效9只眼，有效率为75.0%，两组有效率无明显差异（ P >0.05）。 结论 ETOCD是治疗TON的有效手术方式，且具有微创、侵入性小、术区暴露充分及术野清晰等优势。对于伤后超过72小时且小于两周的患者，手术治疗也具有明显疗效。 Objective To observe the effect of endoscopic transnasal optic canal decompression (ETOCD) on the treatment of traumatic optic neuropathy. Methods A retrospective analysis of 47 patients with TON. The patients were divided into Non-surgical treatment group(16 eyes of 14 cases)and surgical treatment group(33 eyes of 33 cases, ETOCD). Results In 47 cases of TON(49 eyes), 3 eyes' visual acuity was improved in non-operation(3/16) 25 eyes' visual acuity was improved in operation group(8/33) the difference between the two groups was significant(P <0.05). Among the surgical treatment group, 16 eyes' visual acuity was improved in 21 eyes (16/21)with the interval time between injury and operation less than 72 hours. 9 eyes' visual acuity was improved in 12 eyes(9/12)with the time more than 72 hours after injury, there was no significant difference between the two groups( P >0.05). Conclusions ETOCD has the advantages of minimally invasive, adequate surgical exposure and clear field, and also has a significant effect on patients who have been more than 72 hours after injury and less than two weeks.
Evaluation of therapeutic effect of nasal neuroendoscopic decompression on traumatic optic neuropathy
Objective To observe the effect of endoscopic transnasal optic canal decompression (ETOCD) on the treatment of traumatic optic neuropathy. Methods A retrospective analysis of 47 patients with TON. The patients were divided into Non-surgical treatment group(16 eyes of 14 cases)and surgical treatment group(33 eyes of 33 cases, ETOCD). Results In 47 cases of TON(49 eyes), 3 eyes' visual acuity was improved in non-operation(3/16) 25 eyes' visual acuity was improved in operation group(8/33) the difference between the two groups was significant(P <0.05). Among the surgical treatment group, 16 eyes' visual acuity was improved in 21 eyes (16/21)with the interval time between injury and operation less than 72 hours. 9 eyes' visual acuity was improved in 12 eyes(9/12)with the time more than 72 hours after injury, there was no significant difference between the two groups( P >0.05). Conclusions ETOCD has the advantages of minimally invasive, adequate surgical exposure and clear field, and also has a significant effect on patients who have been more than 72 hours after injury and less than two weeks.
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