经鼻腔闭合复位治疗眶内壁骨折  

Replacement of medial orbital wall fracture through nasal cavity

作　　者：吕心红 刘玉珉[2] 张庆云[2] 张加宾[2] 

机构地区：[1]山东省警官总医院五官科,山东济南250002 [2]山东省莱芜市人民医院眼科,山东莱芜271100

出　　处：《眼外伤职业眼病杂志》2009年第9期676-678,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的探讨眶内壁骨折经鼻腔闭合复位术的治疗方法。方法把有眶内容嵌入筛窦的眶内壁骨折68例(68眼)随机分为治疗组和对照组:治疗组进行经鼻腔闭合复位;对照组进行常规药物治疗。观察两组眼球突出度和眶内容疝入筛窦量变化。对有内直肌嵌顿引起麻痹性斜视者观察眼位斜视度和代偿头位度数。结果治疗后30 d、90 d及180 d治疗组眼球突出度均显著高于对照组:治疗后眶内容疝入筛窦量显著减少(u=10.66,P<0.01);原在眼位斜视度显著下降(P<0.01)。代偿头位均被矫正。结论经鼻腔闭合复位治疗眶内壁骨折,可使疝入筛窦的眶内容物大部分还纳入眼眶,减少眶内容疝入筛窦引起的眼窝凹陷和眼球突出度变化。对有内直肌嵌顿引起麻痹性斜视者可有效地降低斜视度和代偿头位度数。Objective To study the surgical management of medial orbital wall fracture through nasal cavity. Methods Sixtyeight patients with medial orbital wall fracture were divided into treatment and control group. Replacement of medial orbital wall fracture through nasal cavity were peffornled in the treatment group. The prominence of eyes, the values of orbital contents herniated into the etbmoidal sinus, the strabismus angles in the primary position and the compensatory head postures were measured before and afteroperation. Results The values of the prominence of eyes in the treatment group were bighter than that in the control group in 30d,90d and 180d after treatment. In the treatment group, the values of orbital contents herniated into the ethmoidal sinus were significantly decreased （ u = 10. 66, P 〈 0.01 ）. The average strabismus angles were significant decreased in the primary position （ P 〈 0.01 ）, and the compensatory head postures were corrected. Conclusion Replacement of medial orbital wall fracture through nasal cavity can return most of the orbital contents that herniated into the ethmoidal sinus. It can decrease values of the enophthalmos and the strabismus angles caused by damage of the medial rectus muscle.

关 键 词：眼眶 骨折 手术 

分 类 号：R779.6[医药卫生—眼科]