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患者男,18岁,新入校学生,因左侧鼻道枪刺刺伤,右眼黑蒙3O分钟于1992年8月31日上午8点40分来院急诊.上午8时许,军训过程中,患者弯腰时左侧鼻道被竖直放置的步枪上三棱刺刀刺中,当时左侧耳道流血,约10分钟后右眼黑蒙,无意识丧失.耳鼻喉科检查.见左侧鼻前庭6mm深伤口,近中鼻甲.立即清创缝合.眼科检查,右眼无光感,瞳孔散大,直径约7mm,直接对光反射消失,间接对光反射存在.晶体及眼底未见异常.左眼视力1.5,未见异常.诊断:1.右眼视神经刺伤?2.颅底开放性骨折.经平卧,妥拉苏林12.5mg、维生素B_(12)0.5mg,地塞米松5mg右眼球后注射等治疗,20分钟后,右眼视力为指数/1m.伤后80分钟,患者感前额部疼痛,恶心,呕吐2次,为咖啡色液体,低头时,左侧鼻道有淡红色液体流出.以颅底开放性骨折,脑脊液骨漏急诊收入脑外科.急诊作头颅CT检查,见鞍上池、环池、四叠体
Patient male, 18 years old, new school student, stabbed by left nasal lancing device, right eye mast 3O minutes to hospital emergency at 8:40 am on August 31, 1992. 8 am, military training process, patients bent Waist left nose was placed vertically on the rifle Prismatic bayonet prick, when the left ear canal bleeding, about 10 minutes after the right eye dark, unconscious loss. ENT examination. See the left side of the nasal vestibule 6mm deep wound , Near the middle turbinate Immediately debridement and suture .Ophthalmological examination, the right eye without light feeling, mydriasis, diameter of about 7mm, direct light reflex disappeared, there is an indirect light reflex. Crystal and fundus no abnormalities. , No abnormalities .Diagnosis: 1. Right optic nerve puncture 2. Open skull base fracture. After supine, tore sulin 12.5mg, vitamin B_ (12) 0.5mg, dexamethasone 5mg right eye after injection After 20 minutes, the right eye acuity index / 1m. 80 minutes after the injury, the patient felt the forehead pain, nausea, vomiting 2 times, brown liquid, bow, the left nasal passage of light red liquid out. Open skull fracture, cerebrospinal fluid leakage emergency surgery brain surgery. Emergency for cranial CT examination, see the saddle pool, Central pool, quadruplex