外伤性视神经病的并发症分析

The complications of traumatic optic neuropathy

目的:探讨外伤性视神经病的并发症,提出防范措施。方法:回顾性分析122例外伤性视神经病患者的临床资料,3例出现严重并发症,其中1例并发化脓性脑膜炎,1例并发颈内动脉假性动脉瘤,1例并发颈内动脉海绵窦瘘。结果:122例外伤性视神经病患者多数伴发眼眶骨折、颌面骨折、眼部及颅脑损伤,少数伴发全身其他部位损害。1例并发化脓性脑膜炎者经抗生素治疗痊愈;1例并发颈内动脉假性动脉瘤者经开颅手术后治愈,此2例患者视力均有明显提高;1例并发颈内动脉海绵窦瘘者死于突发鼻腔大出血。结论:外伤性视神经病有可能并发严重的颅内疾患、眼眶骨折、颌面外伤和内脏及四肢损伤,应提高警惕,进行有效防范和处理。

Objective：To investigate the complications of traumatic optic neuropathy and to call the surgeons attention to precaution. Method： Retrospectively analysis of 122 cases patients with traumatic optic neuropathy and 3 cases were analyzed in detail including 1 case with purulent meningitis,another 1 case with internal carotid artery pseudoaneurysm and the other 1 case with internal carotid artery cavernous sinus fistula. Result： Most of the pa tients had the complications of orbital fracture, maxillofacial fracture, ocular and craniocerebral injury. A few of patients had other injuries all over the body. The case with purulent meningitis was cured with antibiotics. The case with internal carotid artery pseudoaneurysm was cured with neurosurgery. The visual acuity of the both cases were improved. The case with internal carotid artery cavernous sinus fistula died of severe hemorrhea. Conclusion： The patient with traumatic optic neuropathy has the possibility of severe cranial disorders,orbital fracture, maxillofaciat fracture and injuries of viscera or limbs. It should be paid more attention and treated accordingly.