CAJ | 학술논문

目的探讨利用微创技术羟基磷灰石复合人工骨修复爆裂性眶壁骨折的临床效果.方法回顾性分析2008年3月至2010年4月河北医科大学第三医院爆裂性眼眶壁骨折患者21例,鼻内窥镜下窦腔入路,将羟基磷灰石复合人工骨片以桥板式修复骨孔,定期随访6个月,观察预后,评价该方法对功能恢复与解剖复位的效果.结果患者术后均无视力下降及丧失,无感染,骨片无移位、滑脱.随访3个月后复视消失17例,周边视野残余复视2例,第一眼位存在复视2例,其中1例眼球偏斜.6个月后周边视野残余复视患者无明显改善,第一眼位仍存在复视2例,1例眼球偏斜未能恢复.其中复视患者2例给予眼外肌手术进行了矫正.眼球突出度:与健侧眼比较,内陷≤2 mm者18例,内陷＞2 mm者2例,内陷＞4 mm者1例.眼球被动牵拉试验阳性1例.CT扫描:21例均无骨片移位、滑脱.结论此方法结合了鼻内窥镜窦腔入路与羟基磷灰石复合人工骨片的优势,手术效果肯定,有一定推广意义.
목적 탐토이용미창기술간기린회석복합인공골수복폭렬성광벽골절적림상효과.방법 회고성분석2008년3월지2010년4월하북의과대학제삼의원폭렬성안광벽골절환자21례,비내규경하두강입로,장간기린회석복합인공골편이교판식수복골공,정기수방6개월,관찰예후,평개해방법대공능회복여해부복위적효과.결과 환자술후균무시력하강급상실,무감염,골편무이위、활탈.수방3개월후복시소실17례,주변시야잔여복시2례,제일안위존재복시2례,기중1례안구편사.6개월후주변시야잔여복시환자무명현개선,제일안위잉존재복시2례,1례안구편사미능회복.기중복시환자2례급여안외기수술진행료교정.안구돌출도:여건측안비교,내함≤2 mm자18례,내함＞2 mm자2례,내함＞4 mm자1례.안구피동견랍시험양성1례.CT소묘:21례균무골편이위、활탈.결론 차방법결합료비내규경두강입로여간기린회석복합인공골편적우세,수술효과긍정,유일정추엄의의.
Objective To explore a minimally invasive technique with hydroxylapatite artificial bone to repair the orbital blowout fracture.Methods Twenty-one cases of orbital blowout fracture from March 2008 to April 2010 were enrolled.And the fractures were repaired with a bridge of hydroxylapatite artificial bone under a nasal endoscope.During a regular 6-month follow-up,anatomic and functional recovery was evaluated.Results There was neither postoperative visual loss nor infection in all cases.At 3 months postoperation,diplopia vanished completely (n = 17),remained in peripheral vision (n = 2),existed in primary ocular position (n = 2) and the deviation of eyeball (n = 1).At Month 3,diplopia in peripheral vision or in primary position and the deviation of eyeball showed no improvement.Compared with the uninjured side,enophthalmos:≤2 mm (n = 18),＞ 2 mm (n= 2) and ＞ 4 mm (n = 1).The passive traction test was positive in one case.On computed tomograph (CT) scanning,there was no bone dislocation or slippage in all cases.Conclusion The surgical efficacy is excellent.The technique of combining the advantages of endoscopic sinus approach and hydroxyapatite artificial bone is worth a wider popularization.