创伤性眶上裂综合征的治疗  

Management of traumatic superior orbital fissure syndrome(report of 22 cases)

作　　者：陈吉钢 张丹枫[1] 魏嘉良[1] 邹伟[1] 侯立军[1] 

机构地区：[1]第二军医大学长征医院神经外科,上海200003

出　　处：《中国临床神经外科杂志》2016年第4期200-202,共3页Chinese Journal of Clinical Neurosurgery

基　　金：国家自然科学基金(81371382)

摘　　要：目的探讨创伤性眶上裂综合征的治疗方法及其预后。方法 2004年1月到2014年12月收治创伤性眶上裂综合征22例,其中手术治疗15例,保守治疗7例,以眼动神经功能为评价指标。结果在3条眼动神经中,滑车神经损伤最轻,动眼神经次之,外展神经损伤最重;伤后3个月,18(81.8%)例动眼神经功能得到改善。伤后6个月,仅有1例眼动神经功能未得到改善。伤后3个月动眼神经和外展神经评分明显增高(P<0.05),而滑车神经直到伤后6个月才明显增高(P<0.05)。手术治疗与保守治疗各眼动神经恢复程度无显著差异(P>0.05)。结论无明确骨折压迫的创伤性眶上裂综合征可保守治疗;有明确蝶骨骨折、眶上裂狭窄或游离骨片的创伤性眶上裂综合征可考虑手术治疗;总体而言,创伤性眶上裂综合征可以获得较为满意的恢复。ObjectiveTo analyze the management and prognosis of the traumatic superior orbital fissure syndrome（TSOFS）.Methods Of 22 patients with TSOFS who were treated in our department in the recent 10 years, 15 were surgically treated and 7 conservatively. The prognoses were evaluated by the extraocular muscle movement.Results The abducen nerves were first, oculomotor nerves second and trochlear nerves third in order of severity of damage to the nerves in the patients with TSOFS. The extraocular muscle movement function were improved 3 months after the trauma in 81.8% of the patients with TSOFS and 6 months after the trauma in 95.5% of the patients with TSOFS. There was no significant difference in the prognoses between the patients treated surgery and conservative treament（P〉0.05）.Conclusions The conservative treatment is recommended in the patients with TSOFS without sphenoid fracture, who should be treated by steroid hormone. Surgical treatment should be considered if obvious sphenoid fracture is observed or there is superior orbital fissure stenosis in the patients with TSOFS. The partial or complete recovery of cranial nerve function may be expected in most of the patients with TSOFS if the proper treatment is performed.

关 键 词：颅脑损伤 眶上裂综合征 动眼神经 滑车神经 外展神经 治疗 预后 

分 类 号：R651.15[医药卫生—外科学] R651.11[医药卫生—临床医学]