伴发额眶前颅底开放性颅脑损伤的手术治疗

摘要

Objective To explore clinical effect of the surgical repair for the open craniocere-bral injury complicating with anterior cranial base and cranio-orbital traumatic fractures.Methods The clinical data of 33 patients with open craniocer-ebral injury who complicated with anterior cranial base and cranio-orbital traumatic fractures were analyzed retrospectively.One-stage surgical repaired for all the patients,of 7 patients with optic canal injury,4 accepted the one stage cranio-orbital decompressive operation and 3 were delayed for the two-stage operation.Results Of all the patients,no patient happened cerebrospinal leakage,and 7 patients'visual acuity were improved who accepted cranio-orbital decompressive operation.Conclusions For the open craniocerebral injury patients complicating with anterior cranial base and cranio-orbital traumatic fractures,the first job is saving lives,for another,one stage repair for the anterior cranial base and cranio-orbital traumatic fractures and the early cranio-orbital decompressive operation may be conducive to improving neural function.%目的 探讨伴发额眶前颅底开放性颅脑损伤的手术治疗方法、效果.方法 回顾性分析33例额眶前颅底开放性颅脑损伤的临床表现与手术治疗效果.33例患者接受了一期前颅底重建修补术,4例进行一期视神经管减压术,3例二期行视神经管减压术.结果 术后无永久脑脊液漏,7例视神经管损伤,视神经管减压后视力得到改善.结论 颅眶开放性颅脑损伤,重点是抢救生命,一期修复前颅底、眼眶缺损,早期视神经管减压,可减少神经功能障碍,改善患者预后.