额眶损伤的伤情特点及手术处理

目的 总结额眶损伤的伤情特点，探讨额眶损伤早期手术处理的效果。 方法 对广东医学院附属厚街医院神经外科自2001年6月至2009年5月救治的26例额眶部损伤患者的临床资料及手术治疗情况进行回顾性分析。 结果 额眶损伤患者的伤情特点为意识障碍轻、额眶塌陷畸形明显、脑脊液漏及颅神经损伤发生率高。术后随访6～12个月，根据GOS评分分为恢复良好19例，中残6例，重残1例。按面部整形评价标准，17例行额眶整复者术后12例达到整形标准优秀级，5例达到良好级。7例行颅底重建者术后均无脑脊液漏发生,2例行视神经管减压者术后视力改善明显。 结论 额眶损伤在治疗上应积极早期手术，包括颅内血肿清除、挫伤坏死脑组织清除、额眶塌陷畸形整复、颅底修复等，此有助于患者神经功能的恢复及防止颅内感染等。

Traumatic features and surgical treatment of fronto-orbital injury

Objective To summarize the traumatic features of fronto-orbital injury and evaluate its outcome with primary surgical treatment. Methods The clinical data and surgical operative procedures of 26 patients with fronto-orbital injury were analyzed retrospectively.Results The traumatic characteristics of the 26 patients with fronto-orbital injuries are as follows: mild disturbance of consciousness, severe fronto-orbital deformities, and high frequency of cerebrospinal fluid leakage and cranial nerve injuries. Follow-up of 6-12 months was performed; according to Glasgow outcome scale (GOS), 19 patients had good results, 6 moderate disability, and 1 severe disability; according to scale of Jennett and Bond's plastic surgical outcome, among the 17 patients received correction of fronto-orbital deformities, excellent scores were noted in 12 patients and good in 5. Cerebrospinal leakage was effectively obstructed in 7 patients. Visual acuity improved obviously in 2 patients after decompression of optic canal.Conclusion For patients with fronto-orbital injuries, the primary surgical operative procedures include evacuation of intracranial hematoma and contused brain tissue, correction of fronto-orbital deformities, decompression of optic canal, repair of CSF leak, which may be conductive to improving the neural function and decreasing the intracranial infection.