CAJ | 학술논문

目的探讨视神经损伤(TON)视力预后的影响因素.方法回顾性分析2007年6月至2012年6月收治的北京同仁医院685例(719眼)TON患者的临床资料.以性别、受伤侧别、昏迷史、伤后有无残存视力、视神经管是否骨折、蝶骨平台是否骨折、蝶骨大翼是否骨折、蝶窦是否有积血、治疗方式等9个临床观察因素作为自变量(X),术后疗效作为因变量(Y),进行非条件Logistic回归分析,观察可能影响TON预后的影响因素.结果 685例(719眼)总有效率为45.2％(325/719).在9个指标中,伤后昏迷时间(X3,P＜0.01)、伤后残存视力(X4,P＜0.01)、蝶骨大翼骨折(X7,P＜0.01)、治疗方式(X9,P＜0.01)差异有统计学意义,并进入Logistic回归方程.结论伤后无光感、伤后昏迷时间＞0.5h蝶骨大翼骨折是影响TON视力预后的危险因素,而手术治疗则是影响TON视力预后的保护因素.
목적 탐토시신경손상(TON)시력예후적영향인소.방법 회고성분석2007년6월지2012년6월수치적북경동인의원685례(719안)TON환자적림상자료.이성별、수상측별、혼미사、상후유무잔존시력、시신경관시부골절、접골평태시부골절、접골대익시부골절、접두시부유적혈、치료방식등9개림상관찰인소작위자변량(X),술후료효작위인변량(Y),진행비조건Logistic회귀분석,관찰가능영향TON예후적영향인소.결과 685례(719안)총유효솔위45.2％(325/719).재9개지표중,상후혼미시간(X3,P＜0.01)、상후잔존시력(X4,P＜0.01)、접골대익골절(X7,P＜0.01)、치료방식(X9,P＜0.01)차이유통계학의의,병진입Logistic회귀방정.결론 상후무광감、상후혼미시간＞0.5h접골대익골절시영향TON시력예후적위험인소,이수술치료칙시영향TON시력예후적보호인소.
Objective To investigate the relevant factors affecting the prognosis of traumatic optic neuropathy (TON).Methods A total of 685 cases (719 eyes) of TON from June 2007 to June 2012 were analyzed retrospectively.A total of 9 independent variables (X) including sex, side of TON, duration of coma, vision after trauma, fracture of optic nerve canal, fracture of big ridge of sphenoid bone, hematoma in sphenoid sinus and surgical treatment, and the dependent variable (Y) of visual prognosis were analyzed using the unconditioned Logistic regression analysis to find the risk factors for the visual prognosis of TON.Results A total of 325 eyes (45.2％) recovered out of 719 eyes.Four variables showed a significant relation with the visual recovery : duration of coma ＞ 0.5 h (X3 , P ＜ 0.01), remnant vision after trauma (X4, P ＜0.01) and sphenoid ridge fractures (X7, P ＜ 0.01), and surgical treatment (X9, P ＜ 0.01).These factors above were also proved to be significant in Logistic regression.Conclusion The duration of coma ＞ 0.5 h, no light perception after trauma, sphenoid ridge fractures are risk factors of visual recovery, while surgical treatment is the protective factor for the visual recovery after TON.