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目的 探讨颅脑损伤合并视神经损伤的有效治疗方法。 方法 手术治疗 19例颅脑损伤合并视神经损伤病人 ,其中无光感 11例 ,光感 6例 ,眼前手动 1例 ,眼前数指 1例。 16例行额部冠状切开头皮 ,一侧额部开颅清除眶骨骨折片或出血 ,矫正额眶骨折错位畸形。有视神经管骨折者 ,用微钻磨开视神经管 ,剪开视神经鞘进行神经减压。 3例眶尖综合征者行额颞切口 ,经眶尖外侧壁磨开眶上裂和视神经管神经减压。结果 12例有效 ,其中 3例眼球突出、1例眼球内陷均得到矫正。 结论 经额部或额颞入路手术行视神经减压 ,对颅脑损伤合并视神经损伤的病人可取得良好效果。
Objective To investigate the effective treatment of traumatic brain injury combined with optic nerve injury. Methods Surgical treatment of 19 cases of traumatic brain injury with optic nerve injury in patients, including no light perception in 11 cases, light perception in 6 cases, before hand in 1 case, before the count refers to 1 case. 16 cases of the amount of coronal incision scalp, one side of the craniotomy to clear the orbital bone fragments or bleeding, correction of orbital fracture dislocation deformity. Optic nerve canal fracture, with micro-drill open optic canal, cut open the optic nerve sheath nerve decompression. 3 cases of orbital apex syndrome were frontotemporal incision, orbital apex through the lateral wall of the superior orbital fissure and optic nerve decompression. Results 12 cases were effective, including 3 cases of prominent eyeballs, 1 case of eye retraction were corrected. Conclusions Transfraction of the optic nerve through the frontal or frontotemporal approach can achieve good results in patients with traumatic brain injury and optic nerve injury.