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目的 研究视觉诱发电位(VEP)在外伤性视神经病变中的临床价值。方法 外伤性视神经病变37例,其中28例患者为昏迷或不合作或无法检查视力者。全部病例进行VEP检查,16例治疗后7天内视力提高者复查VEP。伤后3个月随访,比较VEP记录不到与VEP有记录者视力恢复情况;观察VEP潜伏期缩短与视力提高的关系;分析VEP与伤后昏迷、伤后视力无光感等外伤性视神经病变危险因素之间的相关性。结果 初期VEP潜伏期延长23例,14例 VEP记录不到。23例 VEP潜伏期延长者中,20例(87%)3个月或以上随访视力提高(P=0．0001);14例 VEP记录不到者中,12例(86%)有伤后昏迷,伤后视力全部无光感,3个月或以上随访视力无提高。治疗后VEP潜伏期缩短与视力提高的关系密切(P＝0.0001);VEP记录不到者最终视力恢复可能性小(RR=6.09,P=0.0001)。结论VEP是外伤性视神经病变早期诊断、疗效观察、预后评价的有效指标。
Objective To study the clinical value of visual evoked potential (VEP) in traumatic optic neuropathy. Methods Traumatic optic neuropathy in 37 cases, of which 28 patients were unconscious or coma or unable to check the eyesight. VEP was performed in all cases, and VEP was retrospectively reviewed in 16 patients with improvement of visual acuity within 7 days after treatment. 3-month follow-up after injury compared VEP recorded with VEP did not restore visual acuity; observed VEP latency and visual acuity shortening relationship; analysis of VEP and post-traumatic coma, visual acuity after injury traumatic optic neuropathy risk Correlation between factors. Results The initial latency of VEP was prolonged in 23 cases and not in 14 cases of VEP. Of the 23 patients with prolonged VEP, visual acuity was improved in 20 patients (87%) at 3 months or more (P = 0.0001). Out of 14 patients with VEP, 12 (86% No visual acuity after injury, no improvement in visual acuity after 3 months or more follow-up. After treatment, the shortening of latent period of VEP was closely related to the improvement of visual acuity (P = 0.0001). The patients with VEP who did not record were less likely to have final visual acuity recovery (RR = 6.09, P = 0.0001). Conclusion VEP is an effective indicator of early diagnosis, curative effect and prognosis evaluation of traumatic optic neuropathy.