眶周创伤的早期整复  

Early reconstruction of the periobital injuries

作　　者：罗金超[1] 归来[2] 张智勇[2] 滕利[2] 朱敬民[1] 郝天智[1] 周至[1] 

机构地区：[1]北京军区总医院烧伤整形科,100026 [2]中国医学科学院整形外科医院

出　　处：《中华整形外科杂志》2008年第5期362-364,共3页Chinese Journal of Plastic Surgery

摘　　要：目的探讨眶周创伤的特点及其治疗方法。方法本组61例患者，其中眶颧骨折30例、额眶骨折6例、鼻筛眶骨折8例、眼眶爆裂骨折7例、眶周多发骨折10例。经详细体检及CT等辅助检查，明确眶周创伤的具体伤情，制定治疗方案。手术采用头皮冠状切口或眉尾小切口，结合睑缘下切口入路及利用局部伤口，充分显露眶周骨折区域；在直视下行骨折复位和内固定，并同期采用钛网及Medpor重建眶壁。结果手术均顺利完成，术后伤口均一期愈合，大多数患者眼眶部外观及功能恢复满意。4例患者二期行眼球摘除术；2例患者术后有不同程度复视，随时间推移逐渐好转：3例患者出现上睑下垂，有待进一步治疗。结论眶周创伤应早期明确诊断，制定有序的治疗计划，早期行眶缘复位固定和眶壁修补重建。Objective To study the clinical characteristics and the treatment of periobital injuries. Methods 61 cases were treated, including 30 cases orbitozygomatie fracture, 6 cases of frontal -orbital fracture, 8 cases of naso-ethmoido-Orbital fracture, 7 cases of blow -out fracture and 10 cases of complicated fracture. The paitents were diagnosed after physical examination and other examination, like CT. Through hicoronal or local minicision at the end of eyebrown, combined with subcillary incision and local wound approach, the fractured sites were exposed completely. Then the fractured fragments were repositioned and fixed rigidly. The orbital wall was reconstructed with titanium net and Medpor. Results The wounds healed primarily. Good cosmetic and functional results achieved in most of the patients. 4 cases underwent second- stage ophthalmectomy. 2 patients had diplopia after operation, but improved gradually. 3 cases of blepharoptosis needed further treatment. Conclusions Early diagnosis and treatment is very important for periorbital injuries Fracture reposition and orbital wall reconstruction should be performed at early period.

关 键 词：眶骨折 复位 内固定 

分 类 号：R779.6[医药卫生—眼科]