外伤性颈动脉海绵窦瘘术后眼球活动恢复不良与静脉引流类型的关系  

Different venous drainage impact on the recover of eyeball movement in patients with traumatic carotid-cavernous fistula

作　　者：康伟民 尹龙[2] 佟小光[2] 田会铭[2] 薛德友[3] 王实[3] 焦德让[3] 薄海 赵贵锋 KANG Wei-min;YIN Long;TONG Xiao-guang(Stroke Medical Therapeutic Center, the General Hospital of PLA Rocket Force, Beijing 100088, China)

机构地区：[1]中国人民解放军火箭军总医院脑卒中医疗救治中心,北京100088 [2]天津市环湖医院神经外科,天津300060 [3]武警后勤学院附属医院神经外科,天津300162

出　　处：《中华全科医学》2018年第5期701-703,764,共4页Chinese Journal of General Practice

基　　金：国家自然科学基金项目(31200894)

摘　　要：目的研究外伤性颈动脉海绵窦瘘(TCCF)的不同静脉引流方式(单纯眼静脉引流或多条静脉引流)对眼部突出、球结膜充血、水肿、眼球活动受限、复视、视力下降的影响。方法将93例有眼部症状的TCCF患者按单纯眼静脉引流或多静脉引流分为单纯眼静脉引流组和多静脉引流组,比较2组患者治疗后眼部突出、球结膜充血、水肿、眼球活动受限、复视、视力下降等症状表现及其愈后情况。结果治疗后,单纯眼静脉引流组和多静脉引流组在眼球突出、结膜充血、水肿、眼球活动受限、视力下降方面,2组比较差异无统计学意义(P>0.05)。多静脉引流组中,15例患者仍然有轻度眼球活动障碍眼球活动受限,术后恢复不佳者在多静脉引流组相对多见,2组治疗结果比较,术后未完全恢复者在多静脉引流组相对多见,差异有统计学意义(P<0.05)。结论外伤性颈动脉海绵窦瘘(TCCF)使用单纯眼静脉引流与多条静脉引流对术后眼球活动受限影响不一。外伤性颈动脉海绵窦瘘眼部症状的恢复除了与TCCF引起的海绵窦内异常血流的改善有关外,多静脉引流所包含的其他因素如岩静脉扩张、深静脉引流等也是影响眼球活动障碍恢复的因素。因此在临床治疗中选择适宜的引流方式值得思考。Objective To explore the effect of single eye vein drainage and multiple venous drainage on proptosis, con- junctival congestion, edema, limited eyeball movement, diplopia, impaired vision in patients with traumatic carotid-cav- ernous fistulas （ TCCF）. Methods Total 93 cases of TCCF were divided into single venous drainage group and multiple venous drainage group. The distribution of ophthalmic symptoms, such as proptosis, conjunctival congestion, edema, limited eyeball movement, diplopia, impaired vision and the outcome were compared between the two groups. Results The symptoms of proptosis, conjunctival congestion, edema, diplopia, impaired vision of these two groups had no differ- ence （P 〉 0.05）. But there were 15 cases of limited eyeball movement in multiple venous drainage after the treatment, and there was a significant difference in these two groups （P 〈 0.05）. Conclusion Different venous drainage for TCCF can make difference in eyeball movement. The recovery of ocular symptoms （ especially limited eyeball movement） of TCCF patients has relationship with the improvement of abnormal blood flow within the cavernous sinus, also with vein ex- pansion and deep vein drainage during multiple venous drainage procedure. So we should choose suitable venous drainage in the treatment.

关 键 词：外伤性颈动脉海绵窦瘘 静脉引流 眼球活动受限 

分 类 号：R743[医药卫生—神经病学与精神病学] R543.4[医药卫生—临床医学]