CAJ | 학술논문

目的：探讨额眶区复杂开放性损伤的Ⅰ期手术治疗方法及临床效果。方法回顾性分析23例额眶区复杂开放性损伤患者的临床资料。23例患者均接受了Ⅰ期清除颅内血肿和坏死脑组织、颅底重建修补、颅眶畸形矫正、视神经探查，其中13例行视神经管减压。结果按格拉斯哥预后量表（ GOS）评分和面部整形评价标准，术后6个月GOS 5分14例，GOS 4分7例，GOS 3分2例。17例达到整形标准优秀级，6例达到良好级。术后无永久脑脊液漏，视神经管减压后视力不同程度改善。结论额眶区复杂开放性损伤，病情复杂，通过多学科联合手术，Ⅰ期清除颅内血肿和坏死脑组织、颅底重建修补、颅眶畸形矫正、视神经管减压，外形结构和功能均可获得良好的临床效果。
목적：탐토액광구복잡개방성손상적Ⅰ기수술치료방법급림상효과。방법회고성분석23례액광구복잡개방성손상환자적림상자료。23례환자균접수료Ⅰ기청제로내혈종화배사뇌조직、로저중건수보、로광기형교정、시신경탐사，기중13례행시신경관감압。결과안격랍사가예후량표（ GOS）평분화면부정형평개표준，술후6개월GOS 5분14례，GOS 4분7례，GOS 3분2례。17례체도정형표준우수급，6례체도량호급。술후무영구뇌척액루，시신경관감압후시력불동정도개선。결론액광구복잡개방성손상，병정복잡，통과다학과연합수술，Ⅰ기청제로내혈종화배사뇌조직、로저중건수보、로광기형교정、시신경관감압，외형결구화공능균가획득량호적림상효과。
Objective To explore the stageⅠsurgical treatment and clinical effects about the complex open orbitofrontal injury .Methods The clinical data of 23 patients with complex open orbitofrontal injury were analyzed retrospectively .All patients were underwent stageⅠoperations of removed of intracranial hematoma and necrotic tissue , reconstructed the cranial base , corrected malformed cranial-orbital bone and probed optic nerve , 13 of them were underwent the optic canal decompression .Results According to Glasgow Outcome Score ( GOS) and the evaluation standard of facial plastic surgery , 6 months after the operation ,of 23 patients,14 were recovered well ,7 moderate disabled ,2 severly disabled .17 patients achieved excellent level of facial plastic , 6 good level . Postoperation no permanent cerebrospinal fluid leakage were found and eyesight improved in different extent after optic canal decompression .Conclusion The complex open orbitofrontal injury need multidisciplinary joint surgery to remove intracranial hematoma and necrotic tissue , reconstruct the cranial base , correct malformed cranial-orbital bone and optic canal decompression .These surgery can make the outside structure and function acquiring a good clinical effect .