頁籤選單縮合
| 題 名 | 治療外傷性視神經病變之臨床經驗--續報 |
|---|---|
| 作 者 | 周秉義; 陳怡均; | 書刊名 | 中華民國眼科醫學會雜誌 |
| 卷 期 | 31:4 1992.12[民81.12] |
| 頁 次 | 頁58-64 |
| 分類號 | 416.73 |
| 關鍵詞 | 外傷性視神經病變; Traumatic optic neuropathy; Optic canal decompression; Megadose steroid; Transantral; Transorbital; Transpterional; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 本研究自民國75年至民國80年總計60例外傷性視神經病變患者提出報 告。其中10例僅嚴密觀察其臨床症狀,未給予任何治療,作為對照組。50例患者 接受口服prednisolone(60-100mg/day)或靜脈注射大劑量dexamethasone(1-3mg/kg/day) 類固醇。其中26例於藥物治療後接受視神經管減壓術,2例經上頜竇,20例經眼 眶,4例經顱內。 對照組中並無明顯視力進步。藥物治療組中,18例有視力進步(36);手術治療組 中,13例視力進步(50)。如果患者於受傷後仍有殘存視力,其預後較受傷後完全 沒有視力者為佳(藥物治療組之進步率分別為57比21;手術治療組之進步率分別 為78比35)。此外根據電腦斷層資料顯示,13例(22)有視神經管骨折。骨折部位 均位於視神經管內壁。此與神經管內壁最薄而易成為外傷時的弱點有關。 |
| 英文摘要 | From 1986 to 1991, sixty cases of sudden blindness following head injury were included in this study. Ten cases were carefully monitored without any kind of treatment; these patients served as controls. Fifty cases received medical and/or surgical treatment. Fifty patients (the medical group) were treated with intravenous dexamethasone or oral prednisolone; twenty six patients (the surgical group) underwent optic canal decompression in addition to medical treatment, 2 by transantral, 20 by transorbital, 4 by transpterional. None of the control patients showed any improvement in visual acuity. Eighteen of the 50 cases(36) in the medical group had visual improvement, while 13 of 26 cases (50) in the surgical group had visual improvement. Patients with vision better than light perception immediately after the trauma benefited more from treatment than did the patients with complete visual loss (57 vs. 21 improved in the medical group; 78 vs. 35 improved in the surgical group). Thirteen of the 60 cases (22) had a fracture of the medial wall of the optic canal, as seen by computed tomographic scan, which was compatible to the anatomical finding, the medial wall was a weak point susceptible to traumatic injury. Sucli optic canal fracture was correlated with poor visual acuity and poor prognosis. |
本系統中英文摘要資訊取自各篇刊載內容。