Diagnosis and treatment of acute craniocerebral injury complicated with optic nerve injury
-
摘要: 目的:探讨急性颅脑损伤并发视神经损伤的病因、损伤机制及其诊治经验。方法:总结2009-02-2011-06我院收治的72例颅脑损伤并发视神经损伤病例,其中手术治疗45例,非手术治疗27例,采用焦氏评价法评价视力。结果:手术治疗病例总有效率84.4%,其中术前视力完全丧失病例有效率为46.2%,术前视力残存病例有效率为100%。非手术治疗病例总有效率63.0%,其中治疗前视力残存病例有效率77.8%,视力完全丧失病例有效率33.3%。结论:视神经损伤总体预后较差,早期诊断和及时治疗是提高视力的关键,有手术指征的应尽早手术治疗。Abstract: Objective: To discuss the cause, injury mechanisms and treatment of craniocerebral injury with optic nerve trauma.Method: Summary 72 patients of craniocerebral injury with optic nerve trauma from February 2009 to June 2011 in TONGREN hospital, 45 patients had surgery, 27 patients were non-surgical treatment.Result: The total effective rate in patients with surgical treatment was 84.4%, the patients with completely vision loss preoperative the effective rate was 46.2%, the patients of visual acuity remaining preoperative, the effective rate was 100%.Non-surgical treatment of patients have 63.0% total effective rate, the patients of visual acuity remaining, the effective rate was 77.8%, the patients with completely vision loss, the effective rate was 33.3%.Conclusion: The prognosis of Optic nerve trauma was poorly, early diagnosis and timely and effective treatment is to improve the vision of an integrated key, the patients with optic nerve trauma should be treated immediately with surgery to testify as early as possible surgery once diagnosed.
-
Key words:
- craniocerebral injury /
- optic nerve injury /
- diagnosis and treatment
-
[1] WONG J F, SOPARKAR C N S, PATINELY J R, et al.Posttraumiaitc Op tic neuropathy[M]//David EEF, John DNG.Evation and treatment of orbital fractures.Amsterdam:Elsevier, 2006:391-400.
[2] 焦保华, 张庆俊, 田剑光, 等颅脑损伤伴发球后视神经损伤的手术治疗[J].河北医学, 1999, 21(1):19-20.
[3] 宋维贤, 庞秀琴, 王景礼.视神经管减压开放术12例疗效观察[J].中华眼科, 2003, 32:448-449.
[4] MARIAK Z.Remote results of conservative treatment of traumate op tic neuropathy[J].Neurol Neurochirpol, 2002, 26:1165-1172.
[5] 孙怀宇, 王鹏.颅底骨折致视神经损伤早期非手术治疗效果观察[J].创伤外科杂志, 2009, 11(5):463463.
[6] 夏小平, 赵丽娜, 田东华.外伤性视神经损伤的治疗方法及手术时机[J].中华急诊医学, 2005, 14:590-592.
[7] MORILLO S M, ESCOLL P, DE LA HERA A, et al.Somatic tetraploidy in specific click retinal ganglion cells induced by nerve growth factor[J].Proc Natl Acad Sci, 2010, 107:109-114.
[8] SIVILIA S, GIULIANI A, FERNÁNDEZ M, et al.Int, ravitreal NGF administration Counteracts retina degeneration after permanent carotid artery occlusion in rat[J].BMC Neurosci, 2009, 10:87-88.
[9] KOUNTAKIS S E, MAILLARD A A, ELHARAZI S M, et al.Endoscopic optic nerve decompression for traumatic blindness[J].Otolaryngol Head Neck Surg, 2000, 123:34-34.
[10] GUPTA A K.Traumatic optic neuropathy in pediatric population:early intervention or delayed intervention[J].Int J Pediatro Otorhinolaryngol, 2007, 71:559562.
[11] FUJITANI T, INOUE K, TAKAHASHI, et al.Indirect traumatic optic neur opathy:visual outcome of operative and nonoperative cases[J].Jpn J Ophthalmol, 1986, 30:125-134.
[12] 李源, 许庚, 谢民强, 等.外伤性视神经病变外科治疗的意义及疗效[J].中华耳鼻咽喉科志, 2002, 37:206-209.
计量
- 文章访问数: 71
- PDF下载数: 22
- 施引文献: 0