早期眼眶骨折患者非手术治疗适应征选择体会

Conservative Treatment of Orbital Fracture in Early Stage

目的总结720例早期眼眶骨折患者分别经保守治疗和手术治疗的随访效果,为非手术治疗的适应征选择提供临床依据。方法收集2005年10月～2010年12月我科经临床及影像学资料证实的720例早期眼眶骨折患者资料,根据其CT表现及临床表现分别选择保守治疗以及手术治疗。非手术治疗适应征包括被动牵拉试验阴性、无眼球内陷,CT片示眼眶骨折破坏面积<1.0 cm2。结果随访结果表明,330例保守治疗患者,眼位均恢复正常;390例手术治疗患者双侧眼位、面颊对称、视功能基本恢复正常。结论熟悉眼眶骨折的CT表现,结合病史及临床表现,早发现,早诊断,适当选择保守或手术治疗,有助于制定对患者最为合适的治疗方案,避免过度手术。

Objective To investigate the indications of conservative treatment of orbital fracture in early stage. Methods From October 2005 to December 2010, 720 cases with orbital fracture were viewed. The indications of conservative treatment included： （1）Negative in traction test; （2） No enophthalmos; （3） The fracture area was less than 1.0 cm2. Other patients will be treated by surgical treatment. Results All cases were followed up for 1-12 months, there was no further ocular mal-position in 330 cases with conservative treatment. The ocular position, facial symmetry and visual function all return to normal in 390 cases with surgical treatment. Conclusion The indications of conservative treatment of orbital fracture in early stage suggested in this study may be useful and can avoid unnecessary operation.