眼眶爆裂性骨折眼球内陷的晚期整复治疗  

Late reconstruction and repositioning of enophthalmos of orbital blow-out fractures

作　　者：范先群[1] 张涤生[2] 冯胜之[2] 徐乃江[1] 

机构地区：[1]上海第二医科大学附属第九人民医院眼科,200011 [2]上海第二医科大学附属第九人民医院整复外科,200011

出　　处：《中华眼科杂志》2002年第11期644-647,I001,共5页Chinese Journal of Ophthalmology

基　　金：上海市青年科技启明星计划基金资助项目(97QBI40 19);上海市卫生系统百名跨世纪优秀学科带头人培养计划基金资助项目 (98BR0 0 5 )

摘　　要：目的　研究眼眶爆裂性骨折眼球内陷晚期手术的方法及疗效 ,评估羟基磷灰石复合人工骨眶内植入的安全性及有效性。方法　应用眼眶三维测量方法及复视分析方法 ,以自体骨及羟基磷灰石复合人工骨作为填充材料 ,对 2 1例眼眶爆裂性骨折眼球内陷患者施行晚期眼眶修复眼球复位术 ,并进行比较研究。结果　 18例患者的眼球内陷被矫正 ,3例治疗无效。 16例复视患者中 ,8例患者复视情况有所改善 ,8例治疗无效。自体骨及复合人工骨眶内植入的疗效无显著差异。结论　眼眶爆裂性骨折眼球内陷的晚期重建复位手术可获得满意疗效。Objective To investigate the surgical technique for late reconstruction and reposition of enophthalmos of orbital blow out fractures (BOF) and its efficacy, and to evaluate the effectiveness of hydroxyapatite (HA) composite material as orbital implant material. Methods Twenty one patients with enophthalmos of BOF were randomly assigned into 2 groups in which autogenous bone and HA composite material as orbital grafting material were used. Computer orbital three dimensional measuring technique, Hertel exophthalmometer and Lancaster test were applied. Late reconstruction of the orbit and reposition of the globe were performed on 21 cases during three months to 2 years after injury. Postoperatively, they were followed up for an average of 8 months. Results In the 21 cases with enophthalmos of BOF, 15 patients presented moderate enophthalmos (3 4 mm) and 6 patients presented severe enophthalmos (5 6 mm). Three months after operation, the measurements demonstrated that 3 patients had no enophthalmos, 15 patients had mild enophthalmos (1 2mm) and 3 patients had no effect. Sixteen of 21 patients had diplopia preoperatively. Eight patients had satisfactory result, and 8 patients had no change. There was no significant difference between orbital implants of autogenous bone and HA composite material. Conclusions Late reconstruction of orbit and reposition of globe for enophthalmos of BOF may obtain satisfactory results. HA composite material is a useful orbital implant material.

关 键 词：眼眶 爆裂性骨折 眼球内陷 晚期整复 复视 羟基磷灰石 

分 类 号：R779.1[医药卫生—眼科]