高密度多孔聚乙烯片在眼眶爆裂性骨折晚期整复中的应用  

Using porous polyethylene sheets in late surgical intervention for orbital blowout fractures

作　　者：范先群[1] 李瑾[1] 刘海燕[1] 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

出　　处：《中华眼科杂志》2003年第9期516-519,共4页Chinese Journal of Ophthalmology

基　　金：上海市卫生系统百名跨世纪优秀学科带头人培养计划 (98BR0 0 5 ) ;上海市青年科技启明星计划 (0 0QMH14 0 6)

摘　　要：目的　评估高密度多孔聚乙烯片眶内植入晚期整复眼眶爆裂性骨折的安全性和有效性。方法　选择 4 2例单侧眼眶爆裂性骨折、眼球内陷≥ 2mm、无眼球破裂伤的患者行晚期 (伤后 1个月以上 )整复治疗。术前均行眼眶CT扫描和三维重建 ,Hertel突眼计测量眼球内陷度数 ,Lancaster红绿灯测量法分析复视情况 ,多孔聚乙烯片眶内植入修复眶壁缺损和复位眼球内陷。术后平均随访 7个月 ,观察项目包括 :视力和矫正视力、眼球突出度、眼位、眼球运动及复视情况 ,并评价其治疗效果。结果　术前 4 2例患者均有眼球内陷 ,术后 2 2例患者眼球内陷完全矫正 ,10例基本矫正 ,10例改善。术前 7例患者眼球下移 ,术后均得到矫正。术前 2 5例患者复视 ,术后 5例复视完全矫正 ,10例改善 ,10例无明显变化。术前 4 2例患者中 19例患者眼球运动受限 ,术后 7例眼球运动恢复正常 ,4例改善 ,8例不变。所有患者均无植入物感染、排出及移位等并发症。结论　多孔聚乙烯片眶内植入治疗眼眶爆裂性骨折安全有效 ;多孔聚乙烯片具有使用方便、随意切割、可塑性强的优点 ,为理想的眼眶植入材料之一。Objective To evaluate the efficacy of using porous polyethylene sheets as orbital implants in late surgical intervention for orbital blowout fractures (BOF). Methods CT scan and 3-D reconstruction were used for the diagnosis of BOF. Hertel exophthalmometer was used for the measurement of enophthalmos. Lancaster test was used for examination of diplopia. Porous polyethylene sheets were used for the repair of orbital defects and the correction of orbital volume expansion on 42 patients with enophthalmos of BOF. The time of surgeries perform was from one month to two years post-injury, and the average duration was six months. The mean follow up time was 7 months. Results Enophthalmos of BOF was corrected in 32 of 42 cases and improved in the rest 10 patients. Twenty-five of 42 patients had diplopia preoperatively. The diplopia disappeared in 5 patients and improved in 10 patients postoperatively. The rest 10 patients had no significant change. Preoperatively 19 of 42 patients had restriction of ductions. Postoperatively, the limited ductions were recovered in 7 cases, improved in 4 cases and no change in 8 cases. No patient had infection and dislocation of implants. Conclusions Porous polyethylene sheets are safe and effective when used for orbital reconstruction.

关 键 词：高密度多孔聚乙烯片 眼眶爆裂性骨折 晚期 整复 安全性 有效性 

分 类 号：R779.1[医药卫生—眼科]