爆裂性眼眶骨折的计算机断层扫描评估及手术

CT evaluation and surgical treatment of blowout orbital fracture

目的探讨爆裂性眼眶骨折的计算机断层扫描（CT）所见及手术治疗方法和效果。方法分析136例（141眼）爆裂性眼眶骨折的临床表现和CT影象，对其中71眼进行复位手术，将嵌顿的眶内容物复位，植入高密度多孔聚乙烯植片或以钛板钛钉铆合的方式修补眼眶骨折缺损，手术后观察眼眶外观、眼球运动、复视的恢复情况。结果由CT影像确定患者中有78眼单纯眼眶内侧壁骨折，18眼单纯眶下壁骨折，36眼双眶壁骨折，9眼混合型骨折。术后眼球内陷的情况明显改善，眼球的运动也灵活很多，复视症状完全消失。结论综合运用眼眶CT横轴位和冠状位扫描，对于显示爆裂性眼眶骨折的影像学征象、决定治疗方案、评估预后都有重要价值。早期手术的效果显著。

Objective To observe CT evaluation and surgical treatment of blowout orbital fracture. Methods The clinical manifestations and CT imaging results of blowout orbital fracture were reviewed in 136 eases （141 eyes）. Surgeries were performed in 71 eyes. The embedded orbital contents were put back, Medpor was implanted or the orbital bone fracture was riveted by titanium plate and titanium screw. The orbital appearance, eyeball movement and diplopia were observed after surgery. Results The CT imaging resuits showed that medial orbital wall fracture in 78 cases, inferior orbital wall fracture in 18 cases, dual orbital fracture in 36 cases and complex orbital bone fracture in 9 cases. After surgery, all cases had better condi- tions of endophthalmos and eye movement. The diplopia disappeared in all cases. Conclusion Orbit coronal and axial CT scanning can show blowout orbital fracture correctly, which is important for choice of surgical procedure and evaluating prognosis.