摘要
目的 回顾性分析15例儿童颅眶盲管伤的诊治经过,总结儿童盲管伤的临床诊治经验.方法 2008年2月至2012年10月我们收治15例颅眶盲管伤患儿,均为锐器物直接自眶顶刺入颅内,术前头颅CT平扫加三维重建及MRI检查,明确眶及颅脑损伤及异物残留部位.13例行额骨瓣开颅硬膜内外联合入路清创,眶及球后清创,完整修补硬膜；2例予保守治疗. 结果 13例患儿随访6个月至5年未发现神经系统功能缺失,1例伴基底节损伤出血的患儿术前有偏瘫,术后随访3年遗留有轻度偏瘫及面瘫,1例中枢神经系统感染后合并脑积水,无手术死亡病例. 结论 儿童锐器经眶顶刺入致颅内盲管伤是特殊类型的外伤,术前详细的体格检查和必要的影像学检查,术中彻底清创,无菌操作严密修补硬脑膜缺损,严防脑脊液外漏,术后预防性使用抗生素能有效降低致残率和死亡率.
Objetive To retrospective analysis of 15 children with cranio-orbital tubular wound,to summarize its clinical experience of diagnosis and treatment.Methods All cranio-orbital tubular wound cases treated in our department from Feb.2008 to Oct.2012 were retrospectively reviewed.The injury approaches were sharp objects piercing the brain tissue through the orbital roof.All patients underwent head CT scan and 3D reconstruction and brain MRI after admission.13 patients underwent frontal craniotomy and inside to outside of the dura mater combined approach surgery to clean the intracranial,orbital roof and eye tissue,then close the dural watertight.The other 2 patients were with conservative treatment.Results 13 patients were followed up for 6 months to 5 years,found no loss of function of the nervous system.One patient has basal ganglia injury found hemiplegia preoperative left hemiparesis and facial paralysis 3-year follow-up after surgery.One patient with central nervous system infections occur during the treatment,and ultimately into hydrocephalus.No deaths in this group.Conclusion Cranio-orbital tubular wound in children is a very special form of trauma.Thoroughly debridement in surgery,tightly close the dural gap to prevent cerebrospinal fluid leaks,prophylactic use of antibiotics can effectively reduce the morbidity and mortality.
出处
《临床小儿外科杂志》
CAS
2013年第5期400-402,共3页
Journal of Clinical Pediatric Surgery
关键词
眼眶
颅脑损伤
诊断
治疗
儿童
Orbit
Craniocerebral Trauma
Diagnosis
Therapy
Child
