视神经鞘开窗术治疗颅内高压性视乳头水肿分析  

The treatment of intracranial hypertension papilledema by using the optic nerve sheath fenestration

作　　者：陈辉[1,2] 樊映川[1] 吴筱芸[3] 梁益[4] 吴德明[5] 杨绍伟[1] 林伟[1] 丘希忠[1] 吴峥峥[1] 潘雪菲[6] 马吴波[6] 赵茂竹[6] 赵秀娟[1] 谭海斌[7] 赖力[3] 兰琦[3] 李忠[3] 

机构地区：[1]四川省医学科学院.四川省人民医院眼科,四川成都610072 [2]四川省医学科学院.四川省人民医院实验动物研究所,四川成都610072 [3]四川省医学科学院.四川省人民医院放射科MRI室,四川成都610072 [4]四川省医学科学院.四川省人民医院神内科,四川成都610072 [5]四川省医学科学院.四川省人民医院后勤技工组,四川成都610072 [6]四川省医学科学院.四川省人民医院城东病区眼科,四川成都610072 [7]四川省医学科学院.四川省人民医院脑外科,四川成都610072

出　　处：《实用医院临床杂志》2013年第6期53-56,共4页Practical Journal of Clinical Medicine

摘　　要：目的观察视神经鞘开窗术(optic nerve sheath fenestration,ONSF)对颅内高压性视乳头水肿的初步疗效。方法以ONSF治疗颅内高压性(包括隐球菌性脑膜炎继发性颅内高压、矢状窦静脉血栓继发性颅内高压、特发性颅内高压和神经梅毒继发性颅内高压)视乳头水肿,观察患者的术后视功能、颅内压、手术并发症等。结果除神经梅毒外,其余患者术后头疼均消失,视乳头水肿迅速减轻并消失。隐球菌性脑膜炎、矢状窦静脉血栓继发性颅内高压性视乳头水肿患者视力得以保存;特发性颅内高压性视乳头水肿、视力、视野明显改善和恢复。结论 ONSF是进行性视功能下降的颅内高压性视乳头水肿的有效治疗方式,手术时间越早,视功能恢复的可能性越大。Objective To observe the effect of optic nerve sheath fenestration （ONSF） on treatment of papilledema. Methods The patients with papilledema caused by intracranial hypertension secondary to Cryptococcus meningitis, sagittal sinus vein thrombosis, idiopathic intracranial hypertension （IIH） and neurosyphilis were treated by ONSF. The visual function, intracranial pressure and the complications were observed. Results Except the neurosyphilis, the headache was resolved and the optic nerve edema was alleviated after operation for Cryptococcus meningitis, sagittal sinus vein thrombosis, and idiopathic intracranial hypertension. Furthermore, the vis-ual function of the patient with Cryptococcus and sagittal sinus vein thrombosis was survived and that of the patient with idiopathic in-tracranial hypertension was improved. Conclusion 0NSF is effective to treat the papilledema patients with progressive visual function loss. The time of surgery is the key for success.

关 键 词：视神经鞘开窗术 视乳头水肿 隐球菌脑膜炎 特发性颅内高压 海绵窦血栓形成 神经梅毒 

分 类 号：R779.6[医药卫生—眼科] R774.62[医药卫生—临床医学]