井冈山大学学报（自然科学版）
井岡山大學學報（自然科學版）
정강산대학학보（자연과학판）
JOURNAL OF JINGGANGSHAN UNIVERSITY(SCIENCE AND TECHNOLOGY)
2013年
2期
99-102
,共4页
吴红云*%刘维峰%胡长青
吳紅雲*%劉維峰%鬍長青
오홍운*%류유봉%호장청
轻型间接视神经损伤%临床特点%发病机制%早期诊断
輕型間接視神經損傷%臨床特點%髮病機製%早期診斷
경형간접시신경손상%림상특점%발병궤제%조기진단
slightly indirect optic nerve injury%clinical features%pathogenesis%early diagnosis
目的对轻型间接视神经损伤的临床特点进行分析.方法回顾性分析我院2009年1月~2012年4月的11例轻型间接视神经损伤临床特点,包括患者的主诉、受伤特点、眼部体征(视力、瞳孔、眼底变化)及辅助检查(视野、视觉诱发电位)并对治疗效果进行总结.结果11例病例的临床特点:患者有患侧颞部及眶区的直接损伤史的受伤特点;视力下降轻;患眼相对传入性瞳孔阻滞(relative afferent pupillary defect,RAPD)阳性;视野:检查有普遍光敏感度下降现象及中心暗点或旁中心暗点或视野缺损;视觉诱发电位(visual-evoked potential ,VEP)示有波幅下降或稍下降或时间延迟;眼眶CT及颅脑CT检查阴性.药物治疗后11例患者复查视野、视觉诱发电位较前改善甚至恢复,其中8例急性外伤患者视力得到完全恢复,3例视力得到明显提高.结论通过对患者主诉、特点、瞳孔异常、视野和视觉诱发电位的分析,能有效的诊断有无视神经的轻度损伤,早期诊治有助于视力恢复.
目的對輕型間接視神經損傷的臨床特點進行分析.方法迴顧性分析我院2009年1月~2012年4月的11例輕型間接視神經損傷臨床特點,包括患者的主訴、受傷特點、眼部體徵(視力、瞳孔、眼底變化)及輔助檢查(視野、視覺誘髮電位)併對治療效果進行總結.結果11例病例的臨床特點:患者有患側顳部及眶區的直接損傷史的受傷特點;視力下降輕;患眼相對傳入性瞳孔阻滯(relative afferent pupillary defect,RAPD)暘性;視野:檢查有普遍光敏感度下降現象及中心暗點或徬中心暗點或視野缺損;視覺誘髮電位(visual-evoked potential ,VEP)示有波幅下降或稍下降或時間延遲;眼眶CT及顱腦CT檢查陰性.藥物治療後11例患者複查視野、視覺誘髮電位較前改善甚至恢複,其中8例急性外傷患者視力得到完全恢複,3例視力得到明顯提高.結論通過對患者主訴、特點、瞳孔異常、視野和視覺誘髮電位的分析,能有效的診斷有無視神經的輕度損傷,早期診治有助于視力恢複.
목적대경형간접시신경손상적림상특점진행분석.방법회고성분석아원2009년1월~2012년4월적11례경형간접시신경손상림상특점,포괄환자적주소、수상특점、안부체정(시력、동공、안저변화)급보조검사(시야、시각유발전위)병대치료효과진행총결.결과11례병례적림상특점:환자유환측섭부급광구적직접손상사적수상특점;시력하강경;환안상대전입성동공조체(relative afferent pupillary defect,RAPD)양성;시야:검사유보편광민감도하강현상급중심암점혹방중심암점혹시야결손;시각유발전위(visual-evoked potential ,VEP)시유파폭하강혹초하강혹시간연지;안광CT급로뇌CT검사음성.약물치료후11례환자복사시야、시각유발전위교전개선심지회복,기중8례급성외상환자시력득도완전회복,3례시력득도명현제고.결론통과대환자주소、특점、동공이상、시야화시각유발전위적분석,능유효적진단유무시신경적경도손상,조기진치유조우시력회복.
Objective:To analyze and summarize the clinical characteristics of slightly indirect optic nerve injury. Methods: A retrospective analysis of the clinical characteristics of 11 cases of light indirect optic nerve injury from January 2009 to April 2012 was done, including the patients’ chief complaints, injury characteristics, eye signs (visual acuity, pupil, fundus changes), and laboratory examinations (vision, visual-evoked potential) and the therapeutic effects was summarized. Results:The clinical features of the 11 cases are as follow, patients having direct injuries of the ipsilateral temporal and orbitofrontal area;slight vision loss;relative afferent pupillary defect, RAPD positive of the injured eye;visual field:universal light sensitivity decline and center or pericentral scotoma or visual field defects; visual-evoked potential (VEP) shows decreased or slightly decreased amplitude or time delay;orbital CT or brain CT is negative. After drug treatment, reexamination of the 11 cases showed recovery of vision and visual evoked potential, or even better than before, including 8 cases full recovery and 3 cases visual acuity significantly improved. Conclusion:It is effective to diagnose the mild optic nerve injury by analyzing the characteristics of patients’ chief complaints, pupil abnormalities, vision and visual-evoked potential, early diagnosis will be beneficial to vision recovery.
