开放性眼球外伤的CT及临床分析  

The CT diagnosis and clinical analysis of open globe injury

作　　者：葛向红[1] 郑文乔 亓卿燕[1] 阎洋 冯雪亮[4] Ge Xianghong;Zheng Wenqiao;Qi Qingyan;Yan Yang;Feng Xueliang(Department of Radiology,Shanxi Eye Hospital,Taiyuan 030001,China;College of Medical Imaging,Shanxi Medical University,Taiyuan 030001,China;College of Medical Imaging,Capital Medical University,Beijing 100069,China;Depatment of Strabismus and Pediatric Ophthalmology,Shanxi Eye Hospital,Taiyuan 030001,China)

机构地区：[1]山西省眼科医院影像科,太原030001 [2]山西医科大学医学影像学院,太原030001 [3]首都医科大学医学影像学系,北京100069 [4]山西省眼科医院斜视与小儿眼科,太原030001

出　　处：《中华眼外伤职业眼病杂志》2021年第3期188-193,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的分析开放性眼球外伤的CT影像特点。方法回顾性分析山西省眼科医院2016年6月至2019年6月363例(363眼)开放性眼球外伤的CT影像资料及手术结果。结果开放性眼球外伤在CT图像上显示眼球变形,体积增大、缩小或正常,可显示玻璃体积血、晶状体损伤、脉络膜脱离、眼内异物、眼眶骨折及眼外肌损伤等,其中271例(74.66%)显示眼球破裂口的位置。经治疗220例(60.61%)保留眼球,143例(39.39%)摘除眼球。玻璃体积血程度、伴发脉络膜脱离、骨折和术前视力差是眼球摘除的危险因素,其中重度积血与伴发骨折者眼球摘除的可能性是无积血者的66.715倍[OR=66.715,95%CI(8.169,544.852)]、无骨折者的2.426倍[OR=2.426,95%CI(1.109,5.308)]。结论CT可以对开放性眼球外伤做出较为明确的诊断,可以较好地显示破裂伤口位置,对眼球及眼眶并发损伤的诊断准确而全面,能够给临床诊断及治疗方案提供可靠的影像学依据,并有助于判断预后。Objective To analyze the CT imaging features of open globe injury.Methods The orbital CT imaging data and surgery results of 363 eyes of 363 cases who were diagnosed as open globe injury from Jun.2016 to Jun.2019 in Shanxi Eye Hospital were analyzed retrospectively.Results The eyeballs were distorted,enlarged,shrunk or normal in size on CT images,which could be complicated with vitreous hemorrhage,lens injury,choroidal detachment,intraocular foreign bodies,orbital fracture and injury of extraocular musle,and so on.In 271 cases(74.66%),the location of the eyeball rupture can be shown on CT images.After treatment,220 cases(60.61%)retained the eyeball,and 143 cases(39.39%)received the enucleation of eyeball.The degree of vitreous hemorrhage,choroidal detachment,fracture and poor preoperative visual acuity were risk factors for enucleation of eyeball.The possibility of enucleation of eyeball in patients with severe hemorrhage and fracture was 66.715 times higher than that in patients without hemorrhage[OR=66.715,95%CI(8.169,544.852)]and 2.426 times higher than that in patients without fracture[OR=2.426,95%CI(1.109,5.308)].Conclusion CT scan can make an accurate diagnosis of open globle injury,it can also show us the location of the rupture to some extent.Furthermore,orbital CT scan is an accurate and comprehensive technique for the diagnosis of the globe and orbital injury.Orbital CT can provide a correct treatment plan and judge the prognosis of eyeball.

关 键 词：外伤 眼球 开放性 断层摄影术 电子计算机 X线 

分 类 号：R779.1[医药卫生—眼科] R816.97[医药卫生—临床医学]