摘要目的 探讨视神经损伤(TON)视力预后的影响因素.方法 回顾性分析2007年6月至2012年6月收治的北京同仁医院685例(719眼)TON患者的临床资料.以性别、受伤侧别、昏迷史、伤后有无残存视力、视神经管是否骨折、蝶骨平台是否骨折、蝶骨大翼是否骨折、蝶窦是否有积血、治疗方式等9个临床观察因素作为自变量(X),术后疗效作为因变量(Y),进行非条件Logistic回归分析,观察可能影响TON预后的影响因素.结果 685例(719眼)总有效率为45.2％(325/719).在9个指标中,伤后昏迷时间(X3,P＜0.01)、伤后残存视力(X4,P＜0.01)、蝶骨大翼骨折(X7,P＜0.01)、治疗方式(X9,P＜0.01)差异有统计学意义,并进入Logistic回归方程.结论 伤后无光感、伤后昏迷时间＞0.5h蝶骨大翼骨折是影响TON视力预后的危险因素,而手术治疗则是影响TON视力预后的保护因素.

abstractsObjective To investigate the relevant factors affecting the prognosis of traumatic optic neuropathy (TON).Methods A total of 685 cases (719 eyes) of TON from June 2007 to June 2012 were analyzed retrospectively.A total of 9 independent variables (X) including sex, side of TON, duration of coma, vision after trauma, fracture of optic nerve canal, fracture of big ridge of sphenoid bone, hematoma in sphenoid sinus and surgical treatment, and the dependent variable (Y) of visual prognosis were analyzed using the unconditioned Logistic regression analysis to find the risk factors for the visual prognosis of TON.Results A total of 325 eyes (45.2％) recovered out of 719 eyes.Four variables showed a significant relation with the visual recovery : duration of coma ＞ 0.5 h (X3 , P ＜ 0.01), remnant vision after trauma (X4, P ＜0.01) and sphenoid ridge fractures (X7, P ＜ 0.01), and surgical treatment (X9, P ＜ 0.01).These factors above were also proved to be significant in Logistic regression.Conclusion The duration of coma ＞ 0.5 h, no light perception after trauma, sphenoid ridge fractures are risk factors of visual recovery, while surgical treatment is the protective factor for the visual recovery after TON.