预成形钛网整体修复眶底和眶内壁联合骨折临床观察  

Clinical study on the reconstruction of orbital floor fracture combined with medial-wall fracture by means of prefabricated titanium mesh

作　　者：陈力[1] 郝晓军[2] 龚波[1] 陶客言[1] 

机构地区：[1] 四川省医学科学院四川省人民医院, 成都610072 [2] 上海市浦东新区浦南医院, 上海200125

出　　处：《中国实用眼科杂志》2014年第7期882-885,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 评价预成形钛网在眶底、眶内壁联合骨折所致眼球内陷中的应用效果.方法 回顾性选择自2012年2月至2013年2月在四川省人民医院眼科诊治的眶底、眶内壁联合骨折病例9例.对比术前及术后三维CT的曲面数据分析,评价眶壁重建的精确性和眼球突出度的恢复情况.结果 所有病例均成功实现了眶壁重建,术后无严重并发症发生.对比眼眶患侧术前与术后的眼眶容积数据,经配对样本t检验,两者差异比较具有统计学意义（t =3.697,P=0.006）,患侧眼眶容积术后比术前明显改善;对比术后两侧眼眶的容积数据,经独立性t检验,两者差异比较无统计学意义（t =2.224,P =0.826）,显示术后双侧眼眶对称性良好;对比术前与术后患侧眼球凹陷数据,经配对样本t检验,两者差异比较具有统计学意义（t =6.167,P＜0.001）,术后眼球凹陷改善明显.容积平均差值为0.67 mm3,平均差异率为3.24％ （6.05/186.79）;双眼突度测量差值＜1 mm者7例,突度差值＜3 mm者1例,1例眼球破裂未计算突度.结论 应用预成形钛网修复眼眶骨折安全、有效,简化了手术操作,钛网重建骨壁位置精准、稳定,眼眶容积、眼球突出度恢复良好.Objective To evaluate the character of the prefabricated titanium mesh which reconstructed the orbital floor and the medial-wall fracture.Methods Nine patients with unilatera orbital fracture of the floor and medial-wall were included,subsequently reconstructed with titanium mesh,and subjected to adequate follow-up with multislice,digitalized computed tomography （CT） images.Medical records were reviewed and the orbital volume and enophthalmos were observed to evaluate the efficacy of the operations.Results In all patients,the volume data of the reconstructed orbit fitted that of the contralateral uninjured orbit by prefabricated titanium mesh.The enophthalmos were corrected and without complications.Conclusions This preliminary study has demonstrated that posttraumatic orbital wall reconstruction using prefabricated titanium mesh results in a high success rate in the re-establishing preoperative bony volume,which closely approximates that of the contralateral uninjured orbit.

关 键 词：眶骨折 钛网 手术治疗 

分 类 号：R473.6[医药卫生—护理学]