高压氧治疗颧骨眶底骨折及其手术所致眶下神经损伤的疗效观察  

Effects of hyperbaric oxygen on infraorbital nerve injury induced by zygomatic orbital floor fractures or surgery

作　　者：章宏毅[1] 李祖兵[1] 

机构地区：[1]武汉大学口腔医学院口腔颌面外科,武汉430079

出　　处：《中华航海医学与高气压医学杂志》2013年第4期236-239,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的 探讨高压氧（hyperbaric oxygen,HBO）治疗对因外伤及手术受损的眶下神经功能恢复的疗效,并了解在HBO干预下这2种损伤后眶下神经功能恢复的预后差异.方法 分析2008年3月以来在我院治疗的57例眶下神经损伤患者的临床恢复情况,其中38例因外伤冲击所致颧骨眶底骨折引起,18例行常规保守治疗（骨折对照组）,20例在此基础上行HBO治疗（骨折HBO组）；另有19例因颧骨眶底骨折后手术复位引起眶下神经损伤,8例行常规保守治疗（骨折术对照组）,11例在此基础上行HBO治疗（骨折术HBO组）.治疗后1周以及1、3、6、12、24个月时复查,了解眶下神经功能恢复情况.以24个月的观察结果为基础判断眶下神经的恢复情况,再分别将2组的恢复状况做比较并行x2检验,以了解HBO对神经恢复的影响.另用x2检验比较2个HBO治疗组眶下神经恢复情况,以了解2种不同病因患者HBO治疗后的预后差异.结果 骨折HBO组神经恢复的效果（好转率90.0％）明显优于骨折术对照组（好转率83.3％）（x2=20.8367,P＜0.05）；骨折术HBO组的神经恢复效果（好转率100.0％）也明显优于骨折术对照组（好转率87.5％）,组间比较差异有统计学意义（x2=40.6526,P＜0.05）；使用HBO治疗的患者,手术组明显优于非手术组（x2=52.5148,P＜0.05）.结论 HBO对外伤与手术损伤的眶下神经恢复有明显的效果,对手术后眶下神经损伤的患者效果更优.对治疗的时间、剂量及相关参数的选择尚待进一步探讨.Objective To explore the therapeutic effect of HBO on infraorbital nerve injury induced by accidental impact or surgery,and also to study differences in the prognosis of neural functional recovery between these two lesions.Methods Recovery of 57 cases of infraorbital nerve injury treated in our hospital since March,2008,was analyzed.Of the 57 cases,38 （the traumatic injury group） had zygomatic orbital floor fractures due to traumatic injury,and 19 （the surgical reposition group） had infraorbital nerve numbness induced by surgical reposition following zygomatic orbital floor fractures.For the patients of the traumatic injury group,18 patients received conventional or conservative therapy,while another 20 patients were given HBO therapy in addition to conventional therapy.All the patients paid return visits,1 week,1 month,3 months,6 months,12 months and 24 months after treatment to find out recovery of infraorbital nerve function.Results of the 2-year examinations were used as reference data to judge if infraorbital nerve function was completely or partially recovered or failed to recover.Then,recovery of the patients in the 2 groups was compared and verified with chisquare tests,so as to know the clinical effects of HBO on the recovery of nerve function.In addition,chisquare test was used to compare the recovery of infraorbital nerve function in patients of the two HBO groups,and also to find out differences in the prognosis of the patients with different causes of disease,following HBO therapy.Results In patients with zygomatic orbital floor fracture induced by accidental impact,neural functional recovery of the HBO group was obviously superior （with an improvement rate of 90%） than that of the non-HBO group （with an improvement rate of 83.8%） （x2 =20.8367,P 〈 0.05）.In the patients that had infraorbital nerve numbness after surgical reposition,neural functional recovery of the HBO group was also obviously superior （with an improvement rate of 100%） than that of the non-HBO group （with

关 键 词：高压氧 眶下神经损伤 颧骨眶底骨折 

分 类 号：R459.6[医药卫生—治疗学]