CAJ | 학술논문

目的：探讨螺旋CT及多种后处理技术对眼眶壁骨折患者的诊断及骨折修复术中的指导价值。方法回顾性分析2010年10月至2013年11月河南省焦作市人民医院眼科收治的86例（86只眼）眶内壁骨折患者的临床资料。采用64层螺旋CT机对患者进行薄层扫描，并利用容积再现技术和多平面重建技术对眶内骨折患者进行重建诊断，以MEDPOR及羟基磷灰石人工骨片为填充材料，对86例眼眶骨折患者实施眶壁骨折整复术。结果多平面重建技术能清晰显示眶内软组织嵌顿及疝出状态，容积再现技术可显示眶壁骨折空间立体结构。经过3个月至2年的术后随访，52例眼球内陷的患者中眼球内陷完全矫正者45例（86．5％），眼球内陷部分矫正者7例（13．5％）。62例复视患者中，复视完全消失者39例（62．9％），复视基本消失者20例（32．2％），较术前加重者3例（4．9％）。结论螺旋CT及多种后处理技术能帮助医生在术前全面了解患者眶内骨折的位置和范围，有助于更好地诊断和治疗眶内骨折。
목적：탐토라선CT급다충후처리기술대안광벽골절환자적진단급골절수복술중적지도개치。방법회고성분석2010년10월지2013년11월하남성초작시인민의원안과수치적86례（86지안）광내벽골절환자적림상자료。채용64층라선CT궤대환자진행박층소묘，병이용용적재현기술화다평면중건기술대광내골절환자진행중건진단，이MEDPOR급간기린회석인공골편위전충재료，대86례안광골절환자실시광벽골절정복술。결과다평면중건기술능청석현시광내연조직감돈급산출상태，용적재현기술가현시광벽골절공간입체결구。경과3개월지2년적술후수방，52례안구내함적환자중안구내함완전교정자45례（86．5％），안구내함부분교정자7례（13．5％）。62례복시환자중，복시완전소실자39례（62．9％），복시기본소실자20례（32．2％），교술전가중자3례（4．9％）。결론라선CT급다충후처리기술능방조의생재술전전면료해환자광내골절적위치화범위，유조우경호지진단화치료광내골절。
Objective To evaluate the clinical significance of spiral CT and post-processing techniques in the diagnosis and prosthesis of orbital wall fracture caused by ocular trauma.Methods The clinical data of 86 patients ( 86 eyes ) with orbital wall fracture who received care in the Department of Ophthalmology,the People′s Hospital of Jiaozuo,Henan,China between October 2010 and November 2011 were retrospectively analyzed.All patients underwent surgical repair of orbital wall fracture with microporous high-density polyethylene implant ( MEDPOR ) filled with hydroxyapatite after 64-thin slice spiral CT scanning and the reconstructive diagnosis through the volume rendering technique and multi-planar reconstruction ( MPR) technique.Results The MPR image clearly revealed the soft tissue incarceration and the status of hernia on the orbital floor,and the volume rendering technique adequately showed the three-dimensional structure of the orbital fracture.During the postoperative follow-up ( range from 3 months to 2 years), 45 (86.5%) injured eyes were completely corrected and 7 (13.5%) were partly corrected.In the 62 patients with diplopia, 39 ( 62.9%) achieved an excellent outcome ( complete disappearance of diplopia) ,20 ( 32.2%) achieved a good outcome ( almost complete disappearance of diplopia ) , but 3 (4.9%)experienced a significant lesion aggravation,after operation.Conclusion Spiral CT and the various available post-processing techniques are very helpful to ophthalmologists in the preoperative investigations of the location and extent of orbital wall fracture and thereby may significantly impact the diagnosis and treatment of orbital wall fracture.