眶下壁骨折伴下直肌嵌顿的手术疗效观察  

Observation on the efficacy of surgeries for the treatment of orbital floor fractures associated with inferior rectus incarceration

作　　者：杨振[1] 丁刚[1] 陈璇[1] 田洁[1] 王玉[1] Yang Zhen;Ding Gang;Chen Xuan;Tian fie;Wang Yu(Department of Ophthalmology, The Second People＇ s Hospital of Ji＇ nan, Ji＇ nan 250021, China)

机构地区：[1]济南市第二人民医院眼科,济南250021

出　　处：《中华眼外伤职业眼病杂志》2017年第12期943-945,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的 观察眶下壁骨折伴下直肌嵌顿的手术疗效.方法 回顾性分析2013年6月至2014年6月6例（6眼）眶下壁骨折伴下直肌嵌顿的临床资料.患者均有眼球向上运动受限及复视,无眼球内陷.所有患者行眼眶骨折整复手术,术中还纳突出入上颌窦的眶内容,骨折区植入Medpor板.观察比较手术前后视力、眼球运动、复视情况及CT检查结果.结果 术后随访观察3个月.伤后2周内手术的5例眼球运动恢复,复视消失;伤后超过2周手术1例眼球运动及复视部分恢复.所有患者术后CT示眶下壁完整,下直肌复位良好.均未发生视力下降.结论 眼眶骨折整复手术可以有效矫正眶下壁骨折伴下直肌嵌顿引起的眼球运动受限及复视,尽早手术可以提高手术效果.Objective To observe the clinical efficacy of surgery for the treatment of orbital floor fractures associated with inferior rectus incarceration .Methods The data of 6 eyes of 6 patients with orbital floor fractures and incarceration of the inferior rectus from Jun .2013 to Jun.2014 were analyzed retrospectively .All cases were with diplopia and restriction of upward motility , without enophthalmos , and underwent orbital fracture reduction surgery .The orbital contents protruding into the cavity of the maxillary sinus were returned , and Medpor was implanted for the reconstruction of the inferior orbital wall .Visual acuity, motility and diplopia and CT results pre-and post-operatively were observed and compared . Results All patients were followed up for 3 months.Motility recovered and diplopia disappeared in 5 cases within 2 weeks after injury and 1 patient received surgery more than 2 weeks after injury showed partial improvement of motility and diplopia .Post-operative CT showed the pavimentum orbitae was intact and the inferior rectus reduction .The visual acuity of all patients were not reduced .Conclusion Orbital floor fracture reduction surgery can effectively correct the restricted motility and diplopia of orbital floor fractures and inferior rectus incarceration .Earlier operation might bring more benefits .

关 键 词：眼眶骨折 下壁 下直肌嵌顿 

分 类 号：R779.6[医药卫生—眼科]