中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2011年
8期
851-853
,共3页
周忠义%柯以铨%杨子才%李平雨%高喜春%曾爱生%尹志钧
週忠義%柯以銓%楊子纔%李平雨%高喜春%曾愛生%尹誌鈞
주충의%가이전%양자재%리평우%고희춘%증애생%윤지균
额骨骨折%眶骨骨折%神经外科手术
額骨骨摺%眶骨骨摺%神經外科手術
액골골절%광골골절%신경외과수술
Frontal fracture%Orbital fracture%Surgery
目的 总结额眶损伤的伤情特点，探讨额眶损伤早期手术处理的效果。 方法 对广东医学院附属厚街医院神经外科自2001年6月至2009年5月救治的26例额眶部损伤患者的临床资料及手术治疗情况进行回顾性分析。 结果 额眶损伤患者的伤情特点为意识障碍轻、额眶塌陷畸形明显、脑脊液漏及颅神经损伤发生率高。术后随访6～12个月，根据GOS评分分为恢复良好19例，中残6例，重残1例。按面部整形评价标准，17例行额眶整复者术后12例达到整形标准优秀级，5例达到良好级。7例行颅底重建者术后均无脑脊液漏发生,2例行视神经管减压者术后视力改善明显。 结论 额眶损伤在治疗上应积极早期手术，包括颅内血肿清除、挫伤坏死脑组织清除、额眶塌陷畸形整复、颅底修复等，此有助于患者神经功能的恢复及防止颅内感染等。
目的 總結額眶損傷的傷情特點，探討額眶損傷早期手術處理的效果。 方法 對廣東醫學院附屬厚街醫院神經外科自2001年6月至2009年5月救治的26例額眶部損傷患者的臨床資料及手術治療情況進行迴顧性分析。 結果 額眶損傷患者的傷情特點為意識障礙輕、額眶塌陷畸形明顯、腦脊液漏及顱神經損傷髮生率高。術後隨訪6～12箇月，根據GOS評分分為恢複良好19例，中殘6例，重殘1例。按麵部整形評價標準，17例行額眶整複者術後12例達到整形標準優秀級，5例達到良好級。7例行顱底重建者術後均無腦脊液漏髮生,2例行視神經管減壓者術後視力改善明顯。 結論 額眶損傷在治療上應積極早期手術，包括顱內血腫清除、挫傷壞死腦組織清除、額眶塌陷畸形整複、顱底脩複等，此有助于患者神經功能的恢複及防止顱內感染等。
목적 총결액광손상적상정특점，탐토액광손상조기수술처리적효과。 방법 대엄동의학원부속후가의원신경외과자2001년6월지2009년5월구치적26례액광부손상환자적림상자료급수술치료정황진행회고성분석。 결과 액광손상환자적상정특점위의식장애경、액광탑함기형명현、뇌척액루급로신경손상발생솔고。술후수방6～12개월，근거GOS평분분위회복량호19례，중잔6례，중잔1례。안면부정형평개표준，17례행액광정복자술후12례체도정형표준우수급，5례체도량호급。7례행로저중건자술후균무뇌척액루발생,2례행시신경관감압자술후시력개선명현。 결론 액광손상재치료상응적겁조기수술，포괄로내혈종청제、좌상배사뇌조직청제、액광탑함기형정복、로저수복등，차유조우환자신경공능적회복급방지로내감염등。
Objective To summarize the traumatic features of fronto-orbital injury and evaluate its outcome with primary surgical treatment. Methods The clinical data and surgical operative procedures of 26 patients with fronto-orbital injury were analyzed retrospectively.Results The traumatic characteristics of the 26 patients with fronto-orbital injuries are as follows: mild disturbance of consciousness, severe fronto-orbital deformities, and high frequency of cerebrospinal fluid leakage and cranial nerve injuries. Follow-up of 6-12 months was performed; according to Glasgow outcome scale (GOS), 19 patients had good results, 6 moderate disability, and 1 severe disability; according to scale of Jennett and Bond's plastic surgical outcome, among the 17 patients received correction of fronto-orbital deformities, excellent scores were noted in 12 patients and good in 5. Cerebrospinal leakage was effectively obstructed in 7 patients. Visual acuity improved obviously in 2 patients after decompression of optic canal.Conclusion For patients with fronto-orbital injuries, the primary surgical operative procedures include evacuation of intracranial hematoma and contused brain tissue, correction of fronto-orbital deformities, decompression of optic canal, repair of CSF leak, which may be conductive to improving the neural function and decreasing the intracranial infection.
