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目的 评价影响外伤性视神经病变预后的相关因素。 方法 回顾分析外伤性视神经病变6 9例的临床资料 ,以伤后 3个月随访视力为最终结果 ,通过多因素分析筛选出影响外伤性视神经病变预后的因素。 结果 6 9例中 3个月以上随访视力无光感者 32例 ,占 4 6 .4 % ;视力进步者 33例 ,占 4 7.8%。伤后视力无光感比有光感以上视力 (P=0 .0 0 31)、伤后有昏迷比伤后无昏迷 (P=0 .0 2 6 2 )、入院前未行常规糖皮质激素治疗比入院前常规应用糖皮质激素治疗 (P=0 .0 184 )、视觉诱发电位 (visual evoked potential,VEP)检查熄灭比 VEP非熄灭者 (P=0 .0 0 0 1)最终视力恢复的危险度增加。 结论 伤后无光感、昏迷、入院前未常规糖皮质激素治疗是影响外伤性视神经病变预后的危险因素 ,VEP检查是评价预后的有效指标。
Objective To evaluate the related factors affecting the prognosis of traumatic optic neuropathy. Methods The clinical data of 69 cases with traumatic optic neuropathy were retrospectively analyzed. The visual acuity of 3 months after injury was taken as the final result. The prognostic factors of traumatic optic neuropathy were screened by multivariate analysis. Results Sixty-three cases were followed up for 32 months with no light perception, accounting for 46.4% of all cases. 33 cases of visual acuity improved, accounting for 4 7.8%. There was no visual acuity in the visual acuity than that in the visual acuity (P = 0.00031), unconsciousness in the unconscious (P = 0.0262) after injury, and no preoperative glucocorticoid (P = 0.014), the visual evoked potential (VEP) was lower than that of the non-VEP non-extinct patients (P = 0.0101) after treatment with the conventional glucocorticoid therapy Increased risk. Conclusion No light sensation and unconsciousness after injury were found. The unconventional glucocorticoid treatment before admission was a risk factor affecting the prognosis of traumatic optic neuropathy. VEP was an effective index to evaluate the prognosis.