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[摘要]
目的:探讨经结膜爆裂性眼眶骨折修补术的手术时机、治疗效果及并发症。
方法:回顾21例施行经结膜眼眶骨折修补术的眼眶爆裂性骨折患者,据伤后手术时间,分为早期组12例、晚期组9例,比较复视、眼球突出度、眶下神经感觉障碍情况,并记录并发症。
结果:复视恢复情况:总体治愈情况(16/21,76.2%); 早期治疗组治愈率(10/12,83.3%)与晚期治疗组治愈率(6/9,66.7%),两组间比较差异有统计学意义(P<0.05); 眼球突出度恢复情况:总体治愈情况(17/21,81.0%); 早期组治愈率(10/12,83.3%)与晚期组治愈率(7/9,77.8%),两组间比较差异无统计学差异(P>0.05); 眶下神经感觉障碍情况:总体治愈率(12/21,57.1%); 早期治疗组治愈率(7/12,58.3%)与晚期治疗组治愈率(5/9,55.6%),两组间差异无统计学意义(P>0.05)。
结论:经结膜切口入路修补眼眶爆裂性骨折是一种手术时间短、损伤小、无皮肤瘢痕、并发症少的方法,值得推广和应用,手术时机在伤后2wk内保守治疗无效情况下为适。
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[Abstract]
AIM: To investigate the operation time, effect and complication of transconjunctival approaches for orbital blowout fractures Medpor reconstruction.
METHODS: Twenty-one patients with orbital blowout fractures were performed transconjunctival approaches for orbital blowout fractures Medpor reconstruction from 2010 to 2014. All the patients were divided into the early operation group(12 cases)and the late operation group(9 cases)based on the treatment time and followed up for 3~12mo. The diplopia, exophthalmos, sensory disturbance degree of infraorbital nerve and complications, effectives of the operation were analyzed and compared.
RESULTS: The cure rate of diplopia was 76.2%(16/21), 83.3%(10/12)in the early operation group and 66.7%(6/9)in the late operation group with statistical difference(P<0.05). The cure rate of enophthalmos was 81.0%(17/21), 83.3%(10/12)and 77.8%(7/9)in the early and later operation group, without statistical difference(P>0.05).T the cure rate of sensory disturbance degree of infraorbital nerve was 57.1%(12/21), 58.3%(7/12)vs 55.6%(5/9)(P>0.05). No operation complications were observed.
CONCLUSION: Medpor reconstruction with transconjunctival approaches is safe, simple and reliable for patients with orbital blowout fractures. Early operation treatment should be performed in two weeks when conservative treatment was not useful.
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