中国脑血管病杂志2012，Vol.9Issue(12)：639-642,4.DOI:10.3969/j.issn.1672-5921.2012.12.006
视神经鞘减压术对颅内静脉窦血栓形成后颅内高压患者视神经的保护作用
Protective effect of the optic nerve sheaths fenestration on optic nerve injury caused by intracranial hypertension in patients with cerebral venous sinus thrombosis
摘要
Abstract
Objective Study on the protective effects of the optic nerve sheaths fenestration on optic nerve injury caused by intracranial hypertension in patients with cerebral venous sinus thrombosis ( CVST) . Methods Thirty six patients with papilledema, impaired vision, and visual field defect caused by CVST related intracranial hypertension were underwent optic nerve sheaths fenestration via conjunctiva approach. The safety of operation was estimated by observing the status of local bleeding at the operative site and the changes of the intracranial pressure. The efficacy of the operation was evaluated by comparing the degree of the improvement of the operated eyes with themselves before operation on the items of the vision, the visual fields and the thickness of retinal nerve fibre layer at day-3 ,7 ,30,90,180 and 360 after operation Results A total of 67 eyes in consecutive 31 patients underwent the optic nerve sheaths fenestration operation at the days of 30-72 after onset of clinical symptoms,from June 2007 to December 2010. The average intracranial pressure before operation was 335 ±45 mm H2O3 visual acuity was 0. 40 ±0. 24,visual field defect was - 16 ± 7 dB, and the thickness of retinal nerve fiber layer was 269 ± 63 μm. No local bleeding and intracranial hypertension aggravation appeared in the cohort of patients during the preoperative period. All the items a-bove were improved remarkably at day-7 after operation ( all P < 0. 01) . The visual acuity, visual field and thickness of retinal nerve fiber layer recovered after operation during 360 days of observation, the peak of the recovery appeared at about day-90 to day-180 after operation. Conclusion Optic nerve sheaths fenes-tration is an effective and safe method on saving the optic nerve injury caused by intracranial hypertension in patients with CVST.关键词
窦血栓形成,颅内/颅内高压/视神经鞘减压术Key words
Sinus thrombosis, intracranial / Intracranial hypertension/ Optic nerve sheaths fenestration引用本文复制引用
张旭乡,杨惠青,吉训明,刘大川..视神经鞘减压术对颅内静脉窦血栓形成后颅内高压患者视神经的保护作用[J].中国脑血管病杂志,2012,9(12):639-642,4.基金项目
北京市自然科学基金资助项目(7122080) （7122080）
北京市科技计划课题资助项目(Z111107067311016) （Z111107067311016）
