摘要
目的比较颅脑创伤合并创伤性眶上裂综合征手术治疗与保守治疗的效果，探讨适应证及手术时机。方法对12例（男7例、女5例）14侧创伤性眶上裂综合征患者的临床资料进行比较，比较手术治疗与保守治疗的效果，形成创伤性眶上裂综合征的初步治疗方案。结果患者平均年龄28岁，平均随访6个月，所有患者均出现了以下症状中的一项或几项：眼球固定、眼睑下垂、眼球突出、角膜反射迟钝或消失、瞳孔散大，以及瞳孔对光反射迟钝或消失。其中1例患者合并眶尖综合征。CT三维重建显示：7例患者眶上裂区有骨折线、骨折片压迫或眶上裂出现变形。7例行手术治疗，其中6例有不同程度恢复。在行保守治疗的5例患者中，3例有不同程度恢复。结论颅脑创伤合并创伤性眶上裂综合征患者年龄普遍较轻，如不及时治疗，将严重影响患者的神经功能。经扩大颧弓入路行眶上裂减压术能改善患者症状，降低致残率，提高患者生存质量。
Objective To compare curative effect of decompression and conservative treatment for traumatic superior orbital fissure syndrome to discuss the operation indications and the operative opportunity for this syndrome. Methods Data of 12 patients （seven males and five females） with 14 sides were compared to evaluate different curative effect between decompression and conservative treatment so as to optimize the initial corresponding treatment. Results The patients were at mean age of 28 years and followed up for mean six months. All patients were complicated by one and more of following symptoms including ophthalmoplegia, ptosis, proptosis and anaesthesia in the distribution of V1 and a fixed dilated pupil. There was one patient complicated by orbital apex syndrome. CT showed involvement of the superior orbital fissure in seven patients. Of seven patients treated with decompression, six got recovery at different degrees. Meanwhile, three out of five patients treated with conservative treatment recovered to some extent. Conclusions Early effective treatment can improve the functional rehabilitation of the injured nerve. Decompression of superior orbital fissure is proved to be effective in ameliorating symptome, reducing disability and improving quality of life.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2009年第3期202-205,共4页
Chinese Journal of Trauma
基金
基金项目：国家自然科学基金资助项目（30672148）
全军医学科学技术研究“十一五”计划课题资助项目（06MB217）
上海市科学技术委员会基础研究重点课题资助项目（07JC14071）
军队“十一五”科技攻关课题资助项目（08a063,06G54）
关键词
脑损伤
手术
外科
预后
眶上裂综合征
Brain injuries
Surgery, operative
Prognosis
Superior orbital fissure syndrome
