额眶损伤的伤情特点及手术处理  

Traumatic features and surgical treatment of fronto-orbital injury

作　　者：周忠义[1] 柯以铨[2] 杨子才[1] 李平雨[1] 高喜春[1] 曾爱生[1] 尹志钧[1] 

机构地区：[1]广东医学院附属厚街医院神经外科,东莞523945 [2]南方医科大学珠江医院神经外科,广东神经外科研究所,广东省脑功能修复与再生重点实验室,广州510282

出　　处：《中华神经医学杂志》2011年第8期851-853,共3页Chinese Journal of Neuromedicine

摘　　要：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。Objective To summarize the traumatic its outcome with primary surgical treatment. Methods features of fronto-orbital injury and evaluate 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.

关 键 词：额骨骨折 眶骨骨折 神经外科手术 

分 类 号：R651.15[医药卫生—外科学]