经结膜切口和经下睑缘切口眼眶爆裂性骨折Medpor修复的对比  

Comparison of transconjunctival and lower lid subciliary approaches for orbital blowout fractures Medpor reconstruction

作　　者：姜倩钰[1] 郭涛[1] 史要武[1] 

机构地区：[1]大连市中心医院眼科,辽宁大连116033

出　　处：《眼外伤职业眼病杂志》2008年第11期869-871,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的对比两种不同切口进行眼眶爆裂性骨折多孔聚乙烯板Medpor修复的疗效。方法回顾性分析96例眼眶爆裂性骨折Medpor修复的手术效果,其中52例采用经结膜切口,44例采用经下睑缘下皮肤切口,术中均在分离还纳眶内容后植入修剪塑形的Medpor板。结果术后眼球突出度较术前均有不同程度的提高,经下睑缘下皮肤切口组提高更为明显。术前存在复视者术后均有改善。经结膜切口组18例术后早期结膜水肿,经治疗后17例消失1例残余小肉芽肿;经下睑缘切口组2例局部瘢痕明显,2例轻度下睑收缩巩膜暴露。结论两种切口行眼眶爆裂性骨折Medpor修复均可有效矫正眼球内陷及复视,但各有其优缺点,经结膜切口无可见瘢痕但术野小术后早期可出现结膜水肿及异物感;经下睑缘下皮肤切口术野暴露充分但术后可形成瘢痕,部分病例可形成下睑收缩或外翻。应根据具体情况选择最佳术式。Objective To compare the effect of two different approaches for orbital blowout fractures Medpor reconstruction. Methods The effect of surgical reconstruction with Medpor implantation of 96 cases of orbital blowout fracture were analyzed retrospectively, among which 52 via transconjunctival approach and 44via lower lid subciliary approach. Results Enophthalmos was improved in both groups, and more significantly in the subciliary group. Complete or partial resolution of preoperative diplopia was achieved in both groups. In the transconjunctival group, conjunetival chemosis appeared in 18 cases early postoperatively, It disappeared in 17 cases left granula in one case after treatment. It the subciliary group, significant facial scar and slight lower lid retraction were observed in 2 cases, respectively. Conclusions Surgical reconstruction with Medpor implantation for orbital blowout fracture via a transconjunctival or a lower lid subciliary approach e - an b - ,ih ： improve the enophthalmos and diplopia effectively, but both of them have their advantages and disadvantages, the transconjunctival approach has no visible scar but the operating field is limited and conjunctival chemosis and foreign body sensation can appear early postoperatively,the lower lid subciliary approach has a wide operating field but visible scar and in some cases lower lid retractioin or ectropion might appear postoperatively. An optimal app _. roach should bechosen individually.

关 键 词：眼眶爆裂性骨折 手术入路 多孔聚乙烯饭 

分 类 号：R779.6[医药卫生—眼科]