CAJ | 학술논문

目的探讨头外伤而非眼球直接受伤后眼眶骨折导致眼球突出的形成机制、临床特点、诊断和治疗方法 . 方法回顾性分析头外伤后眼眶骨折致眼球突出的13例患者(14眼)的致伤原因、临床表现、形成机制、骨折类型、手术时机、手术方式及疗效.术前行眼眶螺旋CT薄层扫描及三维重建,根据骨折部位选择适当手术人路整复骨折或去除骨折片,术后随访. 结果患者均存在不同程度的颅脑损伤,尤以前额受损为主(12例).共14只眼球发生突出,术前平均突出度为(2.94±0.47)mm;8例眼球突出方向为向外下,5例为向前下方.眼眶骨折位于眶上壁或(和)内侧壁,均为眶壁向眶内骨折.手术过程顺利,术后眼部症状迅速消失,无死亡及重度残废病例. 结论头外伤时发生的局部颅骨变形及脑组织移动是导致眶壁向眶内骨折的主要原因,进而使眶内容积变小发生眼球突出.螺旋CT检查对其诊治和随访具有重要意义.应早期手术治疗,效果良好.
목적 탐토두외상이비안구직접수상후안광골절도치안구돌출적형성궤제、림상특점、진단화치료방법 . 방법 회고성분석두외상후안광골절치안구돌출적13례환자(14안)적치상원인、림상표현、형성궤제、골절류형、수술시궤、수술방식급료효.술전행안광라선CT박층소묘급삼유중건,근거골절부위선택괄당수술인로정복골절혹거제골절편,술후수방. 결과 환자균존재불동정도적로뇌손상,우이전액수손위주(12례).공14지안구발생돌출,술전평균돌출도위(2.94±0.47)mm;8례안구돌출방향위향외하,5례위향전하방.안광골절위우광상벽혹(화)내측벽,균위광벽향광내골절.수술과정순리,술후안부증상신속소실,무사망급중도잔폐병례. 결론 두외상시발생적국부로골변형급뇌조직이동시도치광벽향광내골절적주요원인,진이사광내용적변소발생안구돌출.라선CT검사대기진치화수방구유중요의의.응조기수술치료,효과량호.
Objective To study the mechanism, clinical characteristics, diagnosis and treatments of orbital fracture-induced exophthalmos after craniocerebral injury. Methods We retrospectively analyzed the data of 13 patients with orbital fracture-induced exophthalmos after head injury: their causes of injury, clinical situations, types of fracture, operative treatments and surgical outcomes. Spiral CT thin slice scan and three-dimensional reconstruction were performed on the orbit before any treatment, and then, orbital fractures were repaired by corresponding surgical approaches according to the position of fractures and head injury. The effect of operation was evaluated by spiral CT and follow up was performed. Results The patients obviously manifested as having craniocerebral injury and 14 eyeballs in 13 patients had exophthalmos. The average preoperative degree of protrusion was (2.94±0.47) mm.The axial spiral CT together with the reconstructive picture presented the pre- and pro-operative orbital fractures clearly. Orbital fracture positions were situated at superior and medial wall of the orbit. All operations were succeed without death or severe disability. Conclusion The diversify of intracranial pressure is the main reason of orbital fractures which shrinks towards the inter orbit to its volume and induces exophthalmos after craniocerebral injury. The spiral CT examination has vital significance in the diagnosis and treatment of orbital fracture-induced exophthalmos and the patients can obtain good outcome by early surgery.