儿童颅脑外伤致迟发性面神经损伤临床剖析.docVIP

儿童颅脑外伤致迟发性面神经损伤临床剖析 　　[摘要] 目的 探讨儿童颅脑外伤致迟发性面神经损伤临床治疗及预后。方法 方便选取该院2015年1月―2016年1月收治的40例颅脑损伤致迟发性面神经损伤患儿，35例给予保守治疗。5例给予手术治疗，随访5个月，分析患儿治疗效果及预后。结果 40例患儿均经过保守治疗后，根据HB面神经功能恢复评分标准得知，35例患儿治疗有效，恢复至HB评分I～III级，有效率为87.5%。35例患儿中，治愈30例占75.0%；经给予面神经减压术后，均有好转，恢复至II级。听力恢复：术前听力下降的18例患儿中，11例气骨导差缩小到10 dB，5例气骨导差缩小到20 dB，2例重度感音性耳聋听力无改善。结论 儿童颅脑外伤致迟发性面神经损伤，应根据其临床表现，及时诊断，及时治疗，可明显改善患儿预后。 　　[关键词] 儿童颅脑外伤；迟发性面神经损伤；临床治疗；预后 　　[中图分类号] R747 [文献标识码] A [文章编号] 1674-0742（2017）01（a）-0066-03 　　[Abstract] Objective To investigate the clinical treatment and prognosis of delayed facial nerve injury caused by craniocerebral trauma in children. Methods Convenient selection 40 cases of brain in our hospital from January 2015 to January 2016 injury induced by delayed facial nerve injury in children， 35 cases were given conservative treatment.5 patients were treated with surgical treatment， follow-up of 5 months， the treatment effect analysis patients and prognosis. Results 40 cases were after conservative treatment， according to the HB standard for evaluation of facial nerve function recovery that 35 cases with effective treatment， recovery to HB score level I～III， efficiency of 87.5%.35 patients， 30 cases were cured accounted for 75.0%； treated by facial nerve decompression， has improved and recovered to grade II. The recovery of hearing： 18 cases of children with hearing loss before surgery， 11 cases of air bone gap narrowed to 10 dB， 5 cases of air bone gap narrowed to 20 dB， 2 cases of severe sensorineural hearing no improvement. Conclusion Childrens brain traumatic delayed facial nerve injury， according to its clinical manifestations， timely diagnosis， timely treatment， can significantly improve the prognosis. 　　[Key words] Children traumatic brain injury； Delayed facial nerve injury；Clinical treatment； Prognosis 　　在?R床中，小儿颅脑损伤较为常见，而颅脑损伤可引起高达5%的患者出现面神经损伤，患儿多以即可性面神经损伤或迟发性面神经损伤为主要临床表现，如果患儿颅脑损伤伤后3～10 d内出现了面神经损伤就叫做迟发性面神经损伤[1-2]。为探析儿童颅脑外伤致迟发性面神经损伤的临床表现、治疗及预后，该文将2015年1月―2016年1月收治的40例颅脑损伤致迟发性面神经损伤患儿作为研究对象，现报