CAJ | 학술논문

目的：分析外伤性视神经病变的致伤原因，探讨视力预后的影响因素。方法回顾性收集2007年1月至2012年12月在三峡大学仁和医院眼科住院的外伤性视神经病变患者104例（108眼）的临床资料，分析患者的致伤原因，采用多因素Logistic回归分析筛选影响外伤性视神经病变预后的危险因素。结果本组病例平均年龄（33.6±12.8）岁，男95例，占91.3%。致伤原因主要以非机动车、机动车事故为主（84例，占80.8%）。绝大多数患者在伤后3d内就诊（81例，占77.9%）。总体疗效有效率为45.4%（49/108），伤后视力为无光感患眼的有效率为29.9%（20/67），伤后视力为光感及以上患眼的有效率为70.7%（29/41）。多因素Logistic回归分析显示，就诊时间≥伤后24h、眶内出血或眶骨骨折、筛窦/蝶窦出血、伤后无光感是外伤性视神经病变视力预后的独立危险因素。结论就诊时间长和病情严重是影响外伤性视神经病变视力预后的独立危险因素，控制好上述危险因素，对外伤性视神经病变的治疗和预后有重要临床意义。
목적：분석외상성시신경병변적치상원인，탐토시력예후적영향인소。방법회고성수집2007년1월지2012년12월재삼협대학인화의원안과주원적외상성시신경병변환자104례（108안）적림상자료，분석환자적치상원인，채용다인소Logistic회귀분석사선영향외상성시신경병변예후적위험인소。결과본조병례평균년령（33.6±12.8）세，남95례，점91.3%。치상원인주요이비궤동차、궤동차사고위주（84례，점80.8%）。절대다수환자재상후3d내취진（81례，점77.9%）。총체료효유효솔위45.4%（49/108），상후시력위무광감환안적유효솔위29.9%（20/67），상후시력위광감급이상환안적유효솔위70.7%（29/41）。다인소Logistic회귀분석현시，취진시간≥상후24h、광내출혈혹광골골절、사두/접두출혈、상후무광감시외상성시신경병변시력예후적독립위험인소。결론취진시간장화병정엄중시영향외상성시신경병변시력예후적독립위험인소，공제호상술위험인소，대외상성시신경병변적치료화예후유중요림상의의。
Objective To analysis the cause of injury of traumatic optic neuropathy and explore the main factors affecting the prognosis of visual acuity. Methods We retrospectively collected clinical data of 104 cases (108) of traumat-ic optic neuropathy from January 2007 to December 2012 in the Renhe Hospital of Three Gorges University. We then ex-amined the cause of injury and analyzed risk factors for poor prognosis of visual acuity in traumatic optic neuropathy us-ing multivariate Logistic regression analysis. Results The mean age of patients was 33.6 ± 12.8 years and 95 cases (91.3%) were males. The injury was mainly caused by non-motor vehicle and motor vehicle accidents (84 cases, 80.8%). Most of the patients came to the hospital within 3 days after the injury (81 cases, 77.9%). Overall efficacy rate of treat-ment was 45.4%(49/108). The effective rate was 29.9%(20/67) for visual acuity without light perception and 70.7%(29/41) for visual acuity with light perception, respectively. Logistic regression analysis showed that the time to treatment≥24h, orbital hemorrhage or orbital fracture, ethmoid or sphenoid sinus bleeding and no light perception vision were an in-dependent prognostic factors. Conclusion Time to treatment time and severity of injury are the independent risk factors for poor visual prognosis of traumatic optic neuropathy whereas controlling these risk factors has important clinical signifi-cance to the treatment and prognosis of traumatic optic neuropathy.