CAJ | 학술논문

目的分析影响外伤性视神经病变(TON)初期无光感眼的视力预后的因素.方法采用回顾性病例系列研究.对59例(59眼)TON初期无光感患者的临床资料进行回顾分析,通过多因素分析(Logistic回归分析)和单因素分析(x2检验)筛选出影响其视力预后的因素.结果经过糖皮质激素或手术联合糖皮质激素治疗后,14眼(23.73％)视力得到提高.多因素分析显示:合并蝶窦和(或)筛窦积血(OR =0.171,P=0.034)是TON初期无光感眼视力改善的危险因素.受伤48 h后接受治疗(OR=0.233,P=0.079)是TON初期无光感眼视力改善的可疑危险因素.通过单因素分析,VEP有波形(X2=11.232,P=0.001)是TON初期无光感眼视力改善的保护因素.结论 TON初期无光感眼视力预后与多种临床因素有关,是否手术对于预后无明显影响,了解影响视力预后的危险因素和保护因素,有利于临床医师制定合理的临床策略,指导治疗.
목적 분석영향외상성시신경병변(TON)초기무광감안적시력예후적인소.방법 채용회고성병례계렬연구.대59례(59안)TON초기무광감환자적림상자료진행회고분석,통과다인소분석(Logistic회귀분석)화단인소분석(x2검험)사선출영향기시력예후적인소.결과 경과당피질격소혹수술연합당피질격소치료후,14안(23.73％)시력득도제고.다인소분석현시:합병접두화(혹)사두적혈(OR =0.171,P=0.034)시TON초기무광감안시력개선적위험인소.수상48 h후접수치료(OR=0.233,P=0.079)시TON초기무광감안시력개선적가의위험인소.통과단인소분석,VEP유파형(X2=11.232,P=0.001)시TON초기무광감안시력개선적보호인소.결론 TON초기무광감안시력예후여다충림상인소유관,시부수술대우예후무명현영향,료해영향시력예후적위험인소화보호인소,유리우림상의사제정합리적림상책략,지도치료.
Objective To analyse the clinical affecting factors on visual acuity recovery in patients of traumatic optic neuropathy (TON) with initial visual acuity (ⅣA) of no light perception (NLP).Methods A retrospective study was conducted to analyse the clinical characteristics and prognosis of 59 eyes of 59 patients with ⅣA of NLP.The multiple logistic regression analyses and x2 test were used to evaluate potential prognostic factors of visual acuity.Results Fourteen eyes (23.73％) had visual improvement after glucocorticoid or combined surgery and glucocorticoid treatment.Nonconditional logistic regression analysis showed that hemorrhage within ethmoid and /or sphenoid sinus (OR =O.171,P =O.034) was risk factor of visual acuity recovery,and more than 48 hours from injury to treatment (OR =0.233,P =0.079) was potential risk factor of visual acuity recovery.Single factor analysis showed that there were statistically significant differences in prognosis of visual acuity whether wave showing or not in VEP examination (x2 =11.232,P =0.001).Conclusion The visual acuity recovery in patients of TON with ⅣA of NLP is related with many clinical factors.Surgery is not related with visual acuity recovery.Protective and risk factors should be identified,which are beneficial to making clinical strategy and appropriate treatment for clinical physician.