儿童眼眶爆裂性骨折36例临床分析

Clinical analysis of pediatric orbital blowout fractures of 36 cases

目的总结儿童眼眶爆裂性骨折的临床特点及治疗方法，提高对本病的认识。方法对36例眼眶爆裂性骨折的儿童的致伤原因、就诊时间、手术时间、骨折类型、手术方式及预后情况进行回顾性分析。结果36例眼眶骨折的患者中受伤原因依次为撞伤、摔伤、车祸；超过7岁的眼眶骨折患者26例，占72.3％；就诊时间1d至7个月，平均为28d；伤后至接受手术治疗时间，最短4d，最长60d，平均18天；发生于眶下壁19例，占52．7％；眶内壁6例，占16．7％；眶内下壁复合型骨折11例，占30．6％。保守治疗17例，复视消失15例；手术治疗19例，6个月内复视消失15例。结论儿童眼眶爆裂性骨折多发生于眶底，好发年龄为大于7岁。保守治疗对儿童某些线性骨折有效。发生活板门样爆裂性骨折时，越早手术，效果越好。

Objective To evaluate pediatric orbital blowout fractures of the clinical features and treatment methods, raise awareness of the disease. Methods Retrospective analysis of the injury reasons , visiting time , operation time, the types of fractures, surgery and prognosis in 36 cases of pediatric orbital blowout fractures. Results Injured, falls and traffic accidents are the more often reasons in 36 cases of orbital fracture patients;there are 26 cases of orbital fracture more than 7-year-old, accounting for 72.3%;the visiting time is from one day to seven months, with an average of 28 days; the time that after injury to surgery is from 4 days to 60 days, an average of 18 days; infraorbital wall occurred in 19 cases, accounted for 52.7%; orbital floor in six cases, accounting for 16.7%; infraorbital wall with orbital floor in 11 cases, accounting for 30.6%. Conservative treatment of 17 cases, diplopia disappeared in 15 cases; Surgical treatment of 19 cases, diplopia disappeared in 15 cases within six months.Cunclnsiuns Pediatric orbital blowout fractures have more opportunities occurring in the orbital floor, occurred age more than seven years old. Conservative treatment have some effective in children linear fracture. When trapdoor blowout fractures happen , the sooner the surgery begins , the better results are.