眼眶骨折436例临床分析

Clinical analysis of 436 patients with orbital fracture

目的总结眼眶骨折的临床特点及治疗方法,提高对本病的认识。方法对436例(448眼)眼眶骨折治疗前后的致伤原因、临床表现、就诊时间、手术时间、骨折类型及手术方式进行回顾性分析。结果爆裂性骨折305例(317眼),占眼眶骨折69.95%;内陷骨折4例(4眼),占0.92%;复合性骨折127例(127眼),占29.13%。术前平均视力0.691±0.022,术后平均视力0.676±0.030,术前和术后视力差异无统计学意义(P>0.05)。有复视者220例,经治疗治愈114例(51.82%);好转52例(23.64%),总有效率75.45%。视力下降178眼,占39.73%,视力无改变270眼,占60.27%。眼球内陷术前平均为(2.727±0.352)mm;术后平均为(2.615±0.368)mm。术后眼球内陷度较术前明显改善。结论骨折治疗效果与受伤原因、骨折类型、手术时间和手术方法密切相关。

Objective For improving cognitive level about the orbital fracture, the clinical feature of patients troubled with it would be reviewed and summarized. Methods Practice has been put into retrospective analysis of the preoperative etiopathogenisis, clinical feature, visiting time, fractured type, operative time and method in 436 patients （448 eyes） with the orbital fracture, Simultaneously, retrospective appraisal of the postoperative effect was aimed directly at this trauma. Results There were totally 305 cases （317 eyes） blow-out fractures（69, 95% ） , 4 cases （4 eyes） invaginating fractures （0, 92% ）, 127 cases （ 127 eyes） complex fractures （29.13%）. Mean eyesight of the preoperative was about 0. 691 ± 0. 022; that of the postoperative about 0. 676 ± 0. 030. Eyesight change of the preoperative was hardly different from that of the postoperative（ P 〉 0.05 ）. And 220 cases with diplopia, 114 cases were cured （51.82%） ： 52 casas were improved （23.64% ） ： effective rate was 75.46% , 171cases （178 eyes） with visual loss （39. 22% ） , 265 cases （270 eyes） without visual problem （60.78%）. Mean degree of eyeball invaginate at the preoperative was about 2. 727 ± 0. 352 mm; that of the postoperative about 2.615 ±0. 368 mm. There existed in evident improvement between the preoperative and postoperative. Conclusions Prognosis of the orbital fracture is closely related with corresponding items in the above - mentioned methods.