颅脑外伤合并视神经损伤临床分析

目的分析颅脑外伤合并视神经损伤的临床表现,评价其疗效。方法回顾性颅脑外伤合并视神经损伤26例(28只眼)患者的诊断、手术治疗及药物治疗后的视力恢复情况。结果视神经损伤后光感或光感以上者20只眼中,18只眼视力不同程度提高；无光感8只眼中,3只眼视力提高；3例(3只眼)行视神经管减压术者视力提高。结论在第一时间救治颅脑外伤的同时,应抢救视神经损伤后尚存活的神经元,挽救残余视力。确诊后以CT检查有视神经受压迫的阳性征象者,不论有无光感均应及早手术；无阳性征象者及早药物治疗,多途径给药,疗效较好。伤后立即失明者效果差。

Clinical analysis of the craniocerabral trauma with optic nerve damage

Objective To evaluate the situation of the cases of craniocerabral damage with optic nerve injury. Method 26 patients(28 eyes)of craniocerabral damage with optic nerve injury ate retrospecty studies and visual recov- ery after surgical or/and medical treatment.Results 18 of 20 eyes with light perception or better had improvement in the patients who was treated after injury.Only 3 of 8 eyes with no light perception had improvement in the patients who was treated after injury.Conclusion Surgical treatment must be performed as early as possible when optic nerve compression was found by CT,and medical treatment should be performed as early as possible when optic nerve compression was not fount.The visual reeovery was related to the severity of initial inlury and the time of therapy.The visual improvement was poor in the patients with no light perception after trauma.