颅脑损伤后眶顶骨折一期重建15例临床分析  

One-stage reconstruction of orbital roof fracture after head injury

作　　者：王勇[1] 卜战云[2] 史锡文[1] 梁庆华[1] 

机构地区：[1]河南省人民医院神经外科,郑州450003 [2]河南省人民医院眼科,郑州450003

出　　处：《中华神经外科杂志》2013年第3期267-269,共3页Chinese Journal of Neurosurgery

摘　　要：目的探讨颅脑损伤后粉碎性眶顶骨折的临床特征及治疗。方法回顾性分析2006年10月至2012年1月河南省人民医院神经外科收治15例眶顶骨折的临床特点及治疗。结果眶顶缺损面积约为240—320mm^2。合并额骨骨折15例，脑挫裂伤14例，颅内积气9例，硬膜外血肿8例，额颧缝骨折5例，筛骨骨折4例，鼻骨骨折3例，眶下壁骨折1例，眶内侧壁骨折1例。眶周瘀血肿胀15例，突眼2例，脑组织眼漏2例，脑脊液鼻漏2例，眼球破裂2例。采用冠状切口处理额眶区病变，对眶顶缺损应用钛网一期修补。术后复视1例，经眼肌功能训练后好转；脑脊液眼漏、鼻漏各1例，经腰大池外引流后停止。结论一期修补眶顶，可减少眼科和神经外科并发症。Objective To analyze the clinical features and treatments of orbital roof fracture after head injury. Methods A retrospective analysis of 15 patients with orbital roof fracture after head injury in the department of ne＇urosurgery from October 2006 to January 2012 was investigated. Results The defect areas of orbital roof ranged 240 - 320 mm2. Frontal fracture in 15 patients, contusion and laceration of brain in 14 patients, pneumatosis in 9 patients, epidural hematoma in 8 patients, frontozygomatic suture fracture in 5 patients, ethmoid fracture in 4 patients, nasal fracture in 3 patients, orbital floor fracture in 1 patients, orbital medial wall fracture in 1 patients;periorbital edema and ecchymosis in 15 patients, exophthalmos in 2 patients, ophthalmorrhea in 2 patients, rhinorrhea in 2 patients, globe rupture in 2 patients. A coronal incision was applied to treat fronto - orbital fracture . Orbital roof fracture was reconstructed with titanium mesh. Only 1 case complained diplopia after operation, but it recovered normal after 6 months. There were 1 case of ophthalmorrhea and 1 case of rhinorrhea, and they were cured after lumber drainage. Conclusions One-stage reconstruction of orbital roof fracture can reduce diplopia and rhinorrhea.

关 键 词：眶顶骨折 重建 复视 颅脑损伤 

分 类 号：R651.1[医药卫生—外科学]