颅脑损伤伴视神经损伤86例临床分析

目的分析颅脑损伤与视神经损伤的相关因素。方法对外伤性视神经病变86例临床资料进行回顾性分析。结果交通事故为最多致伤原因(53.4%),致伤部位以眼眶部间、直接受伤最为常见(54.7%,其中眉弓部直接致伤为25.6%);伤后无光感13例(13眼),有光感及以上73例(87眼)。6个月以上随访视力进步43例(50.0%)。颅脑损伤后有光感以上视力比无光感、伤后无昏迷比有昏迷视力恢复好。视力恢复还与是否有骨折和视觉诱发电位结果有关。结论颅脑损伤后有无昏迷、视力有无光感是影响视神经损伤预后的主要因素。视神经管断层摄影及视觉诱发电位检查是评价预后的有效指标。

Clinical analysis of 86 patients with head trauma and traumatic optic neuropathy

Objective To evaluate the relevant factors of head trauma and the traumatic optic neuropathy（ TON ）. Methods The clinical data of the 86 patients with TON were analyzed retrospectively. Results The most common causes were traffic accident （53.4%） and directindirect injury to orbit were most frequently （54. 7% ）, including direct injury to the brows （25.6%）. No light perception was found in 13 patients and light perception or above 73. Eyesight recovered well in visual light perception vision and with coma than in no light perception （P 〈 0.01 ）. In addition, the recovery of visual acuity with fractures and visual evoked potential outcomes. Conclusions The effects of traumatic brain injury to the optic nerve after injury with or without coma, visual light perception affect the optic nerve injury prognostic factors. Optic canal tomography and visual evoked potential （VEP） inspection are an effective prognosis indicator in TON.