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  本文選題：外傷性視神經(jīng)病變 + 手術(shù)時機��； 參考：《吉林大學》2010年碩士論文

【摘要】： 目的:探討外傷性視神經(jīng)損傷的損傷機制、診治方式方法、手術(shù)時機、治療原則及預后相關(guān)因素等,總結(jié)目前臨床診治進展,提高臨床醫(yī)師對此病的認識及診治水平。 方法:我們報道了6例病例,4男2女,年齡在19-36歲,均為車禍或高處墜落致傷,并出現(xiàn)不同程度的視力減退(或失明),視野缺失,額眶部皮膚創(chuàng)傷,出現(xiàn)典型的Gunn現(xiàn)象,不同程度的眼球運動障礙等。視神經(jīng)管CT及三維重建提示不同部位的顏面部及視神經(jīng)管壁骨折。均予以臨床藥物及手術(shù)治療�？偨Y(jié)診治過程中的經(jīng)驗,并結(jié)合國內(nèi)外文獻,回顧性分析該病的損傷機制、治療時機、預后情況等。 結(jié)果:分別隨訪2-23個月,結(jié)果4例術(shù)前光感者視力均有不同程度的改善,2例術(shù)前失明患者無效。 結(jié)論:1.藥物輔以視神經(jīng)管減壓治療,療效較單純藥物治療確切。對于傷后即出現(xiàn)失明患者,雖行減壓及藥物治療,但預后不良。預后情況與損傷程度有關(guān)。 2.經(jīng)顱視神經(jīng)減壓術(shù)視野開闊,不僅達到視神經(jīng)的減壓,同時也達到眼動脈減壓�？梢徊⑻幚盹B內(nèi)血腫及腦脊液鼻漏等。 3.因病例較少,在藥物及手術(shù)治療的對照研究、手術(shù)時機、各種手術(shù)方式對照等問題未能形成回歸性分析,希望以后,能進行更大規(guī)模更深層次的探索。
[Abstract]:Objective: to investigate the mechanism of traumatic optic nerve injury, the methods of diagnosis and treatment, the opportunity of operation, the principle of treatment and the related factors of prognosis, and to summarize the progress of clinical diagnosis and treatment at present, and to improve the understanding and diagnosis of the disease by clinicians. Methods: we reported 6 cases with 4 males and 2 females aged between 19 and 36. All of them were injured by traffic accident or falling from a height, with varying degrees of vision loss (or blindness), lack of visual field, frontal and orbital skin trauma, and typical Gunn phenomenon. Different degrees of eye movement disorders and so on. Ct and three-dimensional reconstruction of optic canal indicated facial and optic canal fracture in different position. All patients were treated with clinical drugs and surgical treatment. This paper summarizes the experience of diagnosis and treatment, and analyzes retrospectively the injury mechanism, treatment opportunity and prognosis of the disease in combination with domestic and foreign literature. Results: after follow-up for 2 to 23 months, the visual acuity of 4 patients with preoperative light sensation was improved to some extent, and 2 cases of blindness before operation were ineffective. Conclusion 1. The effect of drug combined with decompression of optic canal is more effective than that of drug alone. Patients with blindness after injury were treated with decompression and medication, but the prognosis was poor. The prognosis was related to the degree of injury. 2. Transcranial optic nerve decompression not only achieved decompression of optic nerve, but also achieved decompression of ophthalmic artery. Intracerebral hematoma and cerebrospinal fluid rhinorrhea can be treated at the same time. Because of the small number of cases, the comparative study of drugs and surgical treatment, the timing of operation, and the control of various surgical methods can not form a regression analysis. It is hoped that in the future, more large-scale and deeper exploration can be carried out.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R774.1

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本文編號：2070885