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目的 :观察鼻内窥镜下视神经减压术的手术及临床效果。方法 :对 8例因外伤致视神经损伤的病例 ,在全麻下行鼻内窥镜视神经减压术 ,并对术中所见、手术时间及术后视力恢复情况进行临床分析。结果 :8例患者均由该术式视神经减压获得成功 ;原发视神经损伤 3例 ,术后视力无改善 ;继发视神经损伤 5例 ,术后视力有明显的恢复 ,视力分别从术前的无光感、光感、手动 /眼前、手动 /眼前、0 0 4提高到术后的 0 1、0 0 8、0 0 6、0 1、0 1。结论 :视神经损伤一旦确定 ,应尽早手术 ,本术式对筛、蝶窦骨折累及视神经、继发视神经损伤及视神经管内壁骨折者为较好选择 ;伤后有光感或视力渐进下降者 ,手术效果较好 ,对伤后无光感的患者 ,应认真分析损伤情况 ,对有视功能改善可能者 ,亦可尽早实施手术 ;手术时间尽早为好 ,但伤后时间较长者 ,亦不能放弃争取视功能改善的机会。
Objective: To observe the operation and clinical effect of optic nerve decompression under nasal endoscopy. Methods: 8 cases of optic nerve injury caused by trauma underwent nasal endoscopic decompression under general anesthesia, and intraoperative findings, operative time and postoperative visual acuity recovery clinical analysis. Results: All the 8 patients were successfully treated by decompression of the optic nerve. The primary optic nerve injury was performed in 3 cases, the visual acuity was not improved after operation. In 5 cases, secondary visual acuity was recovered and visual acuity was recovered obviously. The visual acuity No light feeling, light sense, manual / immediate, manual / immediate, 0 0 4 increased to postoperative 0 1,0 0 8,0 0 6,0 1,0 1. CONCLUSIONS: Once the optic nerve injury is confirmed, surgery should be performed as soon as possible. This procedure is good for screening the sphenoid sinus and the sphenoid sinus involving the optic nerve, secondary optic nerve injury and internal wall fracture of optic canal. The effect is better, no light perception of patients after injury, should carefully analyze the damage situation, for those who have visual function improvement may also be the implementation of surgery as soon as possible; the operation time as soon as possible, but after the injury, those who can not give up Strive for visual function improvement opportunities.