CAJ | 학술논문

目的探讨眼眶爆裂性骨折影像学分析方法,指导临床工作,使治疗更合理和有效.方法回顾性研究2009年9月至2011年10月共收治的73例眼眶爆裂性骨折.其中男性59例,女性14例,平均年龄32.7岁.对患者的临床资料进行综合分析,认真阅读影像资料,注意骨折的性质、位置、范围大小以及眶腔容积的变化,关注眶内软组织、眼外肌与骨折缘的关系及其形态、位置变化等继发改变与临床表现的关系;制定治疗方案.结果手术患者62例,保守治疗患者11例.62例手术患者中,眶下壁骨折39例可见开窗或凹陷性骨折及线性骨折,眶内壁骨折15例以凹陷性骨折居多,眶内、下壁骨折8例可见眶腔明显扩大,在CT影像检查中均看到眼外肌形状态、位置和眶内软组织的继发改变,并通过手术得到验证;对于2例儿童线性骨折有眼外肌嵌夹、复视伴恶心呕吐者,采取急症手术治疗,所有手术患者均达到预期目的.保守治疗患者11例,效果较好.术后随访复查患者眼球内陷得到改善,限制性眼球运动障碍基本消除,影像学检查提示眶腔修复较好、软组织复位、填置物位置良好.结论认真分析影像资料表现,掌握治疗的适应证,把握手术治疗的时机,根据影像学表现松解粘连的眼外肌与影响肌肉运动的纤维机化条索,恢复眼外肌的功能,减少复视的发生率.
목적 탐토안광폭렬성골절영상학분석방법,지도림상공작,사치료경합리화유효.방법 회고성연구2009년9월지2011년10월공수치적73례안광폭렬성골절.기중남성59례,녀성14례,평균년령32.7세.대환자적림상자료진행종합분석,인진열독영상자료,주의골절적성질、위치、범위대소이급광강용적적변화,관주광내연조직、안외기여골절연적관계급기형태、위치변화등계발개변여림상표현적관계;제정치료방안.결과 수술환자62례,보수치료환자11례.62례수술환자중,광하벽골절39례가견개창혹요함성골절급선성골절,광내벽골절15례이요함성골절거다,광내、하벽골절8례가견광강명현확대,재CT영상검사중균간도안외기형상태、위치화광내연조직적계발개변,병통과수술득도험증;대우2례인동선성골절유안외기감협、복시반악심구토자,채취급증수술치료,소유수술환자균체도예기목적.보수치료환자11례,효과교호.술후수방복사환자안구내함득도개선,한제성안구운동장애기본소제,영상학검사제시광강수복교호、연조직복위、전치물위치량호.결론 인진분석영상자료표현,장악치료적괄응증,파악수술치료적시궤,근거영상학표현송해점련적안외기여영향기육운동적섬유궤화조색,회복안외기적공능,감소복시적발생솔.
Objective To study CT imaging features of orbital blow-out fractures.Methods Retrospective study and analysis was made on the clinical records of 73 orbital blow-out fracture patients from September 2009 to October 2011.Sixty-two cases with orbital fracture treated by surgical treatments and 14 cases by conservative treatments were reviewed and summarized.The condition in the diplopia,enophthalmos degree,eyeball position and imaging features were detected.The quality,position,and scope of fractures and the change of orbital cavity must be noticed,and understand the relation between orbital tissues or extraorcular muscles and fractures.Results Sixty-two cases were for operation,and 16 cases were for conservative treatment.The depressed,linear,and open fracture was seen in 39 cases of the fracture of inferior wall of orbit.Most fractures in the internal wall of orbit were depressed fracture.The enlargement of orbital cavity was found in 8 cases of fractures of internal or inferior wall of orbit.The shape,position and secondary changes of extraocular muscles were detected by CT scan,which was confirmed by surgery.Even emergency operations treatment should be taken to the children who had orbit linear fracture with the symptom of incarcerated extraocular muscle,diplopia,nausea and vomiting.The conservative treatment for the patients was effective.Conclusions It is necessary to master the treatment indications strictly,and to relax the adhesive extraorcular and fiber rope according to the imaging features,which can be effective to recover the function of extraocular muscles and alleviate the diplopia of patients.