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目的探讨颅脑损伤合并视神经损伤手术方法及减压的范围。方法翼点入路开颅手术治疗22例颅脑损伤并神经损伤患者,术中磨除骨性视神经管的1/2,切开视神经鞘膜,总腱环及镰状韧带,视神经充分减压。视力评价标准:黑朦、感光、眼前手动、眼前指数和能见标字视力表符号5个级别,术后视力提高2个级别以上者为有效。结果术后3~6个月随访,有效率为81.8%。结论翼点入路手术减压治疗视神经损伤具有较好的效果,术后视力恢复程度与手术时间、手术方法有关,亦与其原发损伤程度密切相关。
Objective To investigate the surgical methods and decompression range of craniocerebral injury combined with optic nerve injury. Methods Twenty-two patients with craniocerebral injury and nerve injury were treated by pterional approach craniotomy. One-half of the optic canal was abraded intraoperatively, and the optic nerve sheath, total tendon ring and sickle ligament were incised. The optic nerve was decompressed adequately . Eyesight evaluation criteria: black, sensory, immediate hand, immediate index and can see the standard visual acuity symbol 5 levels, postoperative visual acuity improved more than 2 levels are valid. Results 3 to 6 months after follow-up, the effective rate was 81.8%. Conclusion The pterional approach decompression for the treatment of optic nerve injury has a good effect. The degree of postoperative visual acuity recovery is related to the operation time and operation method, and is also closely related to the degree of primary injury.