视神经管减压术联合单唾液酸四己糖神经节苷脂对外伤性视神经损伤的疗效观察

目的观察视神经管减压术联合单唾液酸四己糖神经节苷脂（GM-1）对外伤性视神经损伤的治疗效果。方法回顾2006年1月~2011年1月在本院行视神经管减压术治疗的20例外伤性视神经损伤患者的临床资料,其中11例患者联合应用GM-1 100 mg＋5%GS 250 mL,静脉滴注,1次/d,连用2周后,40 mg＋5%GS 250 mL,静脉滴注,1次/d,再连用2周;随访6~12个月,观察患者的视力恢复情况。结果单独手术组和手术联合GM-1组患者的术前一般情况及伤情无明显差异,单独视神经管减压术的9例患者中无改善2例,有效4例,显效2例,特效1例,总有效率77%手术联合GM-1组的11例患者中视力无改善2例,有效3例,显效4例,特效2例,总有效率81%,视力恢复程度优于单独手术组。结论尽早行视神经管减压术清除骨片和血肿对视神经的压迫,及剪开视神经鞘膜和总腱环给受损的视神经纤维释放足够的空间,对视神经的功能恢复起到了关键作用;联合应用单唾液酸四己糖神经节苷脂可以明显促进受损视神经的修复,提高患者的视力恢复程度。

Optic canal decompression combined with GM-1 in the treatment of traumatic optic nerve injury

Objective To evaluate therapeutic effect of optic nerve canal decompression combined with Monosialotetrahexosylganglioside（GM-1） in the treatment of traumatic optic nerve injury.Methods Retrospective analysis of 20 cases of traumatic optic nerve injury patients who underwent optic nerve decompression at our hospital from January of 2006 to January of 2011 was conducted.Among them,11 patients were treated by using GM-1 100 mg ＋5% GS 250 mL/d,ivgtt,for 2 weeks,and then 40 mg ＋5% GS250 mL/d,ivgtt,for 2 weeks.Follow-up of 6 to 12 months was done to observe the patient′s visual acuity recovery.Results The patients of the surgery group（9 cases） and surgery combined with GM-1 group（11 cases） were with preoperative normal conditions and no significant difference was seen in injury.In the separate optic canal decompression group,2 cases had no improvement,4 cases had certain effect,2 cases had obvious effect and 1 case had special effect.The total effective rate was 77%.In the surgery group combined with GM-1,2 cases had no improvement in visual acuity,3 cases had certain effect,4 cases had obvious effect and 2 cases had special effect.The total effective rate was 81%.The visual acuity was better than in combination treatment group than surgery-alone group.Conclusion The early removal of bone chips and hematoma around optic nerve,together with optic nerve sheath incision for nerve osseous decompression plays a key role in promoting recovery of optic nerve function.Optic nerve canal decompression combined with GM-1 can significantly promote the repair of damaged optic nerves and improve vision of patients to varying degrees.