220例眼眶骨折患者复视的临床分析  

Clinical analysis of the visual acuity and the diplopia of 220 patients with orbital fracture

作　　者：林厚维[1] 沈勤[1] 范先群[1] 

机构地区：[1]上海交通大学医学院第九人民医院眼科,上海200011

出　　处：《眼视光学杂志》2007年第5期335-338,共4页Chinese Journal of Optometry & Ophthalmology

摘　　要：目的研究眼眶骨折患者的视力和复视的临床特点。方法观察220例(245眼)患者视力、眼球运动、复视情况,通过眼眶CT观察骨折的部位、范围及眼外肌嵌顿情况。结果骨折侧矫正视力≥1.0的有157眼,<1.0的有88眼,其中<0.3的有23眼。单纯眶壁骨折和复合性骨折的骨折侧视力两者的差异有显著性(P<0.05);195例患者中,149例(76.4%)患者有复视,其中Ⅰ级复视27例,Ⅱ级复视39例外,Ⅲ级复视83例;192只骨折侧眼球(78.4%)存在眼球运动障碍,其中Ⅰ级运动障碍91眼,Ⅱ级运动障碍68眼,Ⅲ级运动障碍33眼;单纯眶壁骨折和复合性眼眶骨折的骨折侧视力差异有显著性(P<0.05),两者的复视和眼球运动障碍存在显著差异(P<0.05)。结论眼眶骨折造成视力下降、复视和运动障碍,复合性骨折的复视程度和运动障碍比单纯眶壁骨折严重。Objective To analyze the clinical features of visual acuity and diplopia in patients after orbital fracture. Methods Vision, eyeball movement and diplopia were observed. The position, range of fractures and the incarceration of the extraocular muscles were observed by CT scan. Results One hundred and fifty-seven eyes with bone fracture had normal corrected vision （≥1.0）, 88 eyes had corrected vision below normal （〈1.0）, and 23 eyes had corrected vision below 0.3. When the visual acuity of the blow-out fracture group and compound fracture group was compared, the difference was significant （P〈0.05）. 149 （76.4%） patients had different degrees of diplopia： 27 had Ⅰ degree, 39 had Ⅱ degree, and 83 had Ⅲ degree. 192 （78.4%） eyes had different degrees of eyeball movement disorder：. 91 had Ⅰ degree, 68 had Ⅱ degree, and 33 had Ⅲ degree. When diplopia in the blow-out fracture group and compound fracture group was compared the difference was also significant （P〈 0.05）. Eyeball movement disorder between the blow-out fracture group and compound fracture group was compared, and the difference was also significant （P〈0.05）. Conclusion A decrease in visual acuity was correlated with orbital fracture. When the two study groups were compared, diplopia and eyeball movement disorders were more severe in compound fractures than in blow-out fractures.

关 键 词：眼眶骨折 视力 复视 眼球运动障碍 

分 类 号：R779.1[医药卫生—眼科]