视神经管减压术在颅脑损伤合并视神经损伤早期治疗中的效果分析

Analysis of clinical effect on the optic canal decompression in the treatment of craniocerebral injury combined with optic nerve injury

目的:探讨颅脑损伤合并视神经损伤患者早期行视神经管减压术的临床意义及诊疗经验。方法:收集我院2005年1月～2010年7月收治的颅脑损伤合并视神经损伤患者72例,术前检查明确合并视神经管骨折患者37例为联合治疗组,采取常规治疗加视神经管减压术;而术前检查未发现视神经管骨折患者35例为常规治疗组,采取常规治疗。通过术后随访比较两组患者术后视力的恢复情况。结果:联合治疗组和常规治疗组分别有4例和1例患者术前诊断完全失明,治疗后仍无法恢复;而在其他的患者中,联合治疗组中术后视力大于0.5的人数(18例)明显高于常规治疗组(8例),差异具有统计学意义(P<0.05)。结论:颅脑损伤伴视神经损伤患者,应严密观察和早期诊断,积极把握手术指征,及早行视神经管减压术,从而减轻视力损伤。

Objective： To discuss the clinical significance and experience of the optic canal decompression in the treatment of craniocerebral injury combined with optic nerve injury.Methods： 72 cases of patients with craniocerebral injury combined with optic nerve injury from January 2005 to July 2010 in our hospital were divided into two groups.37 patients who were diagnosed with craniocerebral injury combined with optic nerve injury in combination therapy group,which was performed in conventional therapy combined with optic canal decompression.35 patients who were not found optic canal fractures before surgery were in Conventional therapy group,which was performed in conventional therapy.Through follow-up,the recovery of postoperative visual acuity of the two groups was compared.Results： Four and one patients diagnosed with total blindness preoperatively in the two groups respectively had no recovery of visual acuity after the treatment.In other patients,the patients whose postoperative visual acuity greater than 0.5 was more in combination therapy group（18 cases） than conventional therapy group（8 cases）,The difference was statistically significant（P〈0.05）.Conclusion： We should observe the patients with craniocerebral injury combined with optic nerve injury closely,make the diagnosis early,hold the surgical indications aggressively,carry out optic nerve decompression early,and in order to reduce the vision damage.