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目的:探讨重型颅脑损伤合并视神经损伤有效诊疗方法。方法:收集重型颅脑损伤合并视神经损伤21例,通过头颅CT平扫及双眼CT薄扫+视神经管冠状位扫描等检查进行诊断,其中2例行内镜经鼻蝶视神经减压,1例行开颅手术中视神经减压,18例非手术治疗视神经损伤。结果:21例均得到正确诊断,治疗后患者意识清楚患者11例,其中视力好转8例,2例视力无明显改善,1例视力完全丧失,植物生存4例,死亡2例。讨论:对于重型颅脑损伤合并视神经损伤患者,通过双眼CT及MRI等检查明确视神经受压及损伤情况,治疗积极采取行视神经减压术、大剂量激素冲击治疗等可取得较好的疗效。
Objective: To explore the effective diagnosis and treatment of severe traumatic brain injury combined with optic nerve injury. Methods: Twenty-one cases of severe craniocerebral injury with optic nerve injury were collected and diagnosed by CT scan of the skull and bilateral thin-section CT scan with coronal scan of optic canal. Among them, 2 cases underwent endoscopic transsphenoidal nerve decompression and 1 case Optic nerve decompression in craniotomy, 18 cases of non-surgical treatment of optic nerve injury. Results: All the 21 cases were correctly diagnosed. Among them, 11 patients were aware of the patients’ consciousness, 8 of them improved visual acuity, 2 had no significant improvement of visual acuity, 1 had complete loss of vision, 4 had plant survival and 2 died. Discussion: For severe craniocerebral injury with optic nerve injury in patients with clear bilateral optic nerve compression and injury by CT and MRI examination, the treatment of optic nerve decompression surgery, high-dose hormonal therapy can achieve better results.