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49 cases of indirect optic nerve injury tube clinical analysis


Fracture of 23 down, 16 down under the wall fracture, comminuted fracture of 4 down, no obvious fracture 6 down. 1.7 The coronal incision in the emergency treatment situation Transcranial optic nerve decompression surgery 42 patients were operated under the microscope with a burr mill addition to stir the neural tube and cut the optic nerve sheath on the wall, conservative treatment of seven cases were all patients upon treatment with large amount of hormone Jing, dehydration drugs, vasodilator and neurotrophic drugs. McNair is usually used bolus methylprednisolone 500 a lO00mg, day 1, continuous intravenous infusion of 3 days, then gradually reduce, 2096 mannitol 125 - 250ml, 2 times a day intravenously, Nemo with 10 ~ 2Orng, daily or continuous infusion pump infusion of people, drugs such as intravenous piracetam injection disgrace. Visual acuity 1.8 manual and the immediate circumstances of the 19 cases of light perception after surgery were higher than the front of a l-foot Bureau of the number of fingers, visual acuity gradually improved within six months, up to 0.8, the lowest of 0.1, the average up to 04. No immediate hand preoperative light perception in 23 cases, 8 cases surgical start one week in the visual acuity improved to present a number of means-foot, visual acuity gradually improved within six months, up to 0.5, the lowest of 0.1, the average 03 . The other 15 cases of no recovery of wood in hand with conservative treatment in 7 cases, one week before the hand after the limited sense of an inverted light buildings. Two months later, visual acuity was no significant increase, the other 6 cases no significant increase after treatment. Section 2 discuss the 2-1 pipe connected with the optic nerve or optic canal fracture means a pipe optic nerve contusion caused by optic nerve injury. Closed head injury with the incidence of nerve injury Chui Fu 0.5% to 4%, most often unilateral + scoop week the Ministry of the forehead or the amount of damage caused. The disease occurs mostly in the age of 10 - 40 year old male, is mostly caused by traffic accident injury. In order to save vision, early diagnosis, early treatment is extremely important. More complex mechanism of indirect optic nerve damage, blindness, mechanisms can be divided into primary and secondary. It has been reported for 22 patients with no light perception. Not blindly surgery,[link widoczny dla zalogowanych], hormone therapy observed by dehydration after Ha, selective surgery, good results u. But we are 49 down through the optic nerve canal treatment of indirect injury, 23 cases of hand-free vision of wood before, eight cases were observed after the effective + efficient%. Therefore, we believe that McNair is certainly secondary to optic nerve injury after injury that is still continuing decline in visual acuity or visual acuity in patients with immediate surgery. Can not determine the primary or secondary injury after optic nerve injury that is no vision the patient, once diagnosed, should be immediately underwent emergency surgery. 2.3 on conservative treatment and surgical treatment, Mi cry so in 12 cases of surgical patients and 24 patients without surgery after treatment compared t that vision before surgery in patients with hand or light perception, visual acuity significantly improved after surgery. The same visual acuity before treatment in patients with hand or light perception, visual acuity significantly improved after surgery, patients without post-operative visual acuity was not significant _2_. 7 down our conservative treatment,[link widoczny dla zalogowanych], effective 1 down, but not significantly improved visual acuity. Makz other 1O down in the conservative treatment of patients after 3 to 11 years long-term effects observed after high-dose hormone therapy,[link widoczny dla zalogowanych], 6 patients with no visual side after injury, 4 do have a weak eyesight ineffective in patients with 2 to 3 Council tax force to 0, respectively. 06,0.1, O5,[link widoczny dla zalogowanych], 0.7, 4 to 6 years but the deterioration of visual acuity after 3 down, only light perception, optic atrophy, an inverted vision for the 002. Finally: Even if conservative treatment is satisfactory, but long-term vision whether or not reliable J. We believe that: as the stretch of pipe segments connected by the injury in question should be to face,[link widoczny dla zalogowanych], the choice of surgery, with immediate manual or light perception, emergency surgery immediately. Ha manual light perception, we observed 23 side of the patients, 8 post-operative side effect. Active treatment should be in operation as soon as conditions permit, but with large doses of hormones and dehydration treatment of drug raid. 3