儿童trapdoor眼眶骨折临床分析  

Clinical analysis on orbital trapdoor fracture in children

作　　者：李晓明[1] 宋鄂[1] 魏世辉[2] 

机构地区：[1]吉林大学第一医院眼科,吉林省长春市130021 [2]解放军总医院眼科,北京市100853

出　　处：《眼科新进展》2010年第7期658-660,共3页Recent Advances in Ophthalmology

摘　　要：目的通过分析儿童trapdoor眼眶骨折病例,探讨儿童trapdoor眼眶骨折的常见病因、临床表现及手术疗效。方法回顾2003年1月至2009年10月确诊为儿童眼眶爆裂性骨折21例患儿,11例11眼为trapdoor眼眶骨折。对11例患儿进行临床回顾性分析。结果 11例trapdoor眼眶骨折患儿主要眼部表现为患眼上转伴下转受限10例(90.9%)、仅上转受限1例(9.1%),眼球运动垂直位转动受限伴恶心、呕吐7例(63.6%),手术距受伤时间间隔为10～36d,平均(17.0±6.9)d。术后随访1～2个月,眼球上转、下转受限较术前均有轻度改善,但双眼向下注视仍存在复视。结论 Trapdoor眼眶骨折主要临床表现为患侧垂直位眼球运动障碍,可伴恶心、呕吐,眶部CT表现为眶下壁一窄裂,下直肌等眶内软组织常被箝闭于骨折处。晚期手术(伤后10d以上)疗效欠佳。Objective To explore the common causes,clinical manifestation and therapeutic efficacy of orbital trapdoor fracture in children by analyzing children with orbital trapdoor fracture.Methods Twenty-one cases with orbital blowout fracture were analyzed from January 2003 to October 2009,and there were 11 cases（11 eyes,52.38%）with orbital trapdoor fracture.Clinical characteristics of children with orbital trapdoor fracture were retrospectively analyzed.Results Clinical manifestations of 11 cases with orbital trapdoor fracture were restricted superduction and restricted deorsumduction in 10 cases（90.9%）,only restricted superduction in 1 case（9.1%）,restricted oculogyria at vertical position combined with nausea and vomiting in 7 cases（63.6%）.Time interal between injury and surgery was from 10 days to 36 days with an average of （17.0±6.9）days.All cases were followed up for 1 month to 2 months,restricted superduction and restricted deorsumduction were improved compared with those before surgery,but diplopia was still found.Conclusions The main clinical manifestations of orbital trapdoor fracture are ocular motility disorders at vertical position,nausea and vomiting.CT result of orbital part shows a linear fracture at paries inferior orbitae.Soft tissues in orbit as inferior rectus muscle are always blocked at fracture.Surgery at later stage（more than 10 days after injury）can’t achieve a better curative efficacy.

关 键 词：TRAPDOOR 眼眶骨折 儿童 

分 类 号：R779.1[医药卫生—眼科]