中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2011年
8期
581-583
,共3页
眶底骨折%手术入路%疗效
眶底骨摺%手術入路%療效
광저골절%수술입로%료효
Orbital floor fracture%Surgical approach%Healing effect
目的 探讨整复眶底骨折不同手术入路的临床选择方法。方法 37例爆裂性眶底骨折根据骨折部位分为3组,分别采用下睑睫毛下入路(13例)、上颌窭入路(17例)以及联合手术入路(7例)进行手术,观察眼球突出度、眼球运动障碍、被动牵拉试验结果以及复视情况,并进行手术前后对比。结果 术前3组患者均有垂直复视和眼球运动障碍,眼球被动牵拉试验阳性(牵拉眼球向上遏阻力),双眼眼球突出度相差＞4 mm者29例,相差在2～4mm者8例。术后3组患者的双眼眼球突出度相差均在2mm以内,眼球被动牵拉试验阴性。下睑睫毛下入路组的全部13例和上颌窦入路组17例中的12例,眼球运动恢复正常,复视消失。上颌窦入路组中5例和联合手术入路组的全部7例,术后仍有眼球下转受限,向下方注视时复视仍存在。结论 对于需要手术整复的爆裂性眶底骨折,根据骨折部位,临床选择不同的手术入路可取得良好疗效。
目的 探討整複眶底骨摺不同手術入路的臨床選擇方法。方法 37例爆裂性眶底骨摺根據骨摺部位分為3組,分彆採用下瞼睫毛下入路(13例)、上頜窶入路(17例)以及聯閤手術入路(7例)進行手術,觀察眼毬突齣度、眼毬運動障礙、被動牽拉試驗結果以及複視情況,併進行手術前後對比。結果 術前3組患者均有垂直複視和眼毬運動障礙,眼毬被動牽拉試驗暘性(牽拉眼毬嚮上遏阻力),雙眼眼毬突齣度相差＞4 mm者29例,相差在2～4mm者8例。術後3組患者的雙眼眼毬突齣度相差均在2mm以內,眼毬被動牽拉試驗陰性。下瞼睫毛下入路組的全部13例和上頜竇入路組17例中的12例,眼毬運動恢複正常,複視消失。上頜竇入路組中5例和聯閤手術入路組的全部7例,術後仍有眼毬下轉受限,嚮下方註視時複視仍存在。結論 對于需要手術整複的爆裂性眶底骨摺,根據骨摺部位,臨床選擇不同的手術入路可取得良好療效。
목적 탐토정복광저골절불동수술입로적림상선택방법。방법 37례폭렬성광저골절근거골절부위분위3조,분별채용하검첩모하입로(13례)、상합구입로(17례)이급연합수술입로(7례)진행수술,관찰안구돌출도、안구운동장애、피동견랍시험결과이급복시정황,병진행수술전후대비。결과 술전3조환자균유수직복시화안구운동장애,안구피동견랍시험양성(견랍안구향상알조력),쌍안안구돌출도상차＞4 mm자29례,상차재2～4mm자8례。술후3조환자적쌍안안구돌출도상차균재2mm이내,안구피동견랍시험음성。하검첩모하입로조적전부13례화상합두입로조17례중적12례,안구운동회복정상,복시소실。상합두입로조중5례화연합수술입로조적전부7례,술후잉유안구하전수한,향하방주시시복시잉존재。결론 대우수요수술정복적폭렬성광저골절,근거골절부위,림상선택불동적수술입로가취득량호료효。
Objective To study the clinical choice of surgical approach in the treatment of orbital floor fracture. Methods 37 patients with orbital floor fracture were divided into 3 groups by the site of fracture and received 3 surgical approach include incision under the eyelashes ( 13 case) ,through the maxillary sinus ( 17 cases) ,or both two surgical approach (7 cases). To compare the degree of proptosis,ocular motility forced retraction test,diplopia before and after surgery. Results 37 patients had vertical diplopia, abnormal eye vertical movement, positive forced retration test ( to pull the eye upword with resistance), and the difference in degree of proptosis more than 4mm in 29 case,2 -4mm in 8 cases before surgery. After the surgery,all the patients had negtive forced retraction test ( to pull the eye upword with no resistance)and less than 2mm in the difference of proptosis' degree. All 13 cases in incision under the eyelashes group and 12 cases in through the maxillary sinus grpup recovered in eye movement and diplopia. 5 cases in through the maxillary sinus group and all 7 cases in the joint surgery group had underaction of ocular movement and diplopia on downgaze. Conclusion To choice different surgical approach in the treatment of orbital floor fracture,good healing effect could be available.
