| Objective:To analyze the effect of glucocorticoid therapy in patients with optic nerve contusion,and analyze the influencing factors of the effect.?Methods:1?materials:From January 2010 to September 2017,86 cases(86 eyes)of optic nerve contusion patients who received glucocorticoid therapy and were collected from the Department of Ophthalmology,China and Japanese Hospital,Jilin University.A statistical analysis of the clinical datas of these patients was carried out retrospectively.The clinical datas of these patients were statistically analyzed retrospectively.Gender,age,trauma factors,complications,time of visit,visual acuity before and after treatment,and the number of cases treated were recorded.2?groups:Age is divided into 3 stages: less than 40 years,40 to 60,over 60 years of age(Including 60 years old).The visit time is divided into 1 day(including 1 day)and more.Before treatment,visual acuity was divided into two groups: group A: below index,group B: 0.02 ~0.1,group A : 0.1 or more.The treatment regimen was divided into two groups: group A(large dose of glucocorticoid shock therapy,sodium methylprednisolone for injection,trade name: methylprednisolone 1000 mg,intravenous drip,treatment course 3 days,once a day,and then the gradual decrement was 500mg??250mg?125mg?62.5mg,each for 1 to 3 days,all of them were taken in order of one day,later,instead of oral prednisone acetate tablets,1mg/kg/d,less than 60 mg,reduced to 10 mg and given orally for a week.group B(routine glucocorticoid therapy,dexamethasone 10 mg / g,intravenous drip,course of treatment is 3~5 days,once a day,gradually reduced and replaced by oral administration)3?analyse datas :The visual acuity of patients before and after treatment was recorded and expressed as mean ±standard deviation,and the effective rate was expressed as percentage.By using the software of Excel,SPSS,the curative effect sample size of the recorded data was analyzed by chi-square test and chart analysis.The?2?P value was calculated(P < 0.05),which had significant statistical significance,otherwise,there was no statistical significance.?Results:1?A total of 86 patients with optic nerve contusion were collected in this experiment,all of which were monocular pathogenic.Of them,58 were males and 28 were females.Age: < 40 years old: 52 patients,aged 40 to 60: 26patients;older than 60: total 8patients.There were 75 cases of accident injury,7 cases of falling object injury or falling injury,4 cases of others.There were 4 cases of iridocyclitis,6 cases of secondary glaucoma,2 cases of light dislocation of lens and 2 cases of vitreous hernia(non-pupil area).Visual acuity before treatment: the visual acuity of 21 cases below index,0.02 ~ 0.1 were 19 cases and above 0.1 46 cases.44 cases were treated within 1 day,42 cases were treated over 1 day.group A(42 eyes),the visual acuity was 0.114 ±0.158 before treatment and visual acuity 0.366 ±0.401 after treatmentin,group B(38 eyes),the visual acuity was 0.135 ±0.163 before treatment and 0.343 ±0.327 after treatment.2?comparison of therapeutic effects in different visit time: ?2=12.21,P=0.0005.Comparison of different visual acuity before treatment between group a and group c: ?2=13.83,P=0.0002,group b vs group c: ?2=4.143,P=0.0417.The effects of glucocorticoid therapy on visual acuity(Visual acuity improved by more than 0.5)of group A was significantly higher than that of group B(?2=7.88,P=0.0005 < 0.005).Conclusion:The factors influencing the prognosis of the patients with optic nerve contusion in this study were the time of seeing a doctor,the severity of visual impairment after injury,and the recovery of visual acuity in patients with visual acuity above 0.1 after injury within 24 hours.The final therapeutic effect of high dose glucocorticoid was not better than that of routine glucocorticoid therapy,but the visual acuity improved more than 0.5 in 3 days before treatment. |
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