眼眶骨折168例临床分析

Clinical analysis of 168 cases with orbital fracture

目的通过分析眼眶骨折患者的临床资料,探讨其致伤原因、临床特点及治疗方法。方法 对2012年6月至2013年6月确诊眼眶骨折住院治疗的患者168例（180眼）进行回顾性分析。结果 168例180眼患者中爆裂骨折137眼（含多壁复合骨折8眼）、直接骨折17眼、合并眶颧颌复合体骨折26眼。168例180眼患者中保守治疗88例（98眼）、手术治疗80例（82眼）;手术指征：眼球内陷35例（35眼）,复视及眼球运动受限24例（24眼）,内陷合并复视19例（21眼）,内陷合并严重眼球破裂伤2例（2眼）,眶颧颌复合体患者尚合并颜面畸形和（或）张口困难等功能障碍。手术时机：伤后3～21d,平均10.57d。随访3个月,所有患者眼球内陷、复视、颜面畸形和（或）张口困难等均痊愈或明显改善,总有效率100.00%。结论 眼眶骨折致伤原因复杂,对此类患者应详细检查、及时诊治,可有效避免并发症和后遗症。

Objective To analyze the reasons, clinical characteristics and treatment of orbital fracture with clinical data. Methods From June 2012 to June 2013,158 patients （ 180 eyes） with the diagnosis of orbital fracture were retrospectively analyzed. Results In 180 eyes,there were 137 eyes with orbital blowout fracture,17 eyes with active fracture, and 25 eyes with zygomatico-orbital fracture. 88 cases （98 eyes） were treated with conservative treatment, and 80 cases （82 eyes） were treated with operation. Surgical indications included enophthalmos in 35 cases （35 eyes）, diplopia and limited eye movement in 24 cases（ 24 eyes）, enophthalmos combined with diplopia in 19 cases（21 eyes）, enophthalmos combined with ophthalmorrhexis in 2 cases （ 2 eyes）, and zygomatico-orbital fracture combined with dysfunction （facial deformity or difficult rictus）. Operation opportunity was from 3 days to 21 days after trauma,averaged 10.57 days. The patients were following up for 3 months. The symptoms of enophthalmos, diplopia,facial deformity or difficult rictus had recoveried or obviousiy improved,and the total effective rate was 100%. Conclusion The reasons of orbital fracture are corn-plicated. The careful examination and timely treatment can effectively avoid the complications and sequelae.