北部战区总医院军人眶壁骨折手术治疗的情况分析

Analysis of soldiers’ orbital wall fracture surgical treatment in General Hospital of Northen Theater Command

目的:探讨军人发生眶壁骨折的临床特点与手术治疗效果。方法:收集2015-01-01/2018-12-31因眶壁骨折就诊于我院行手术治疗的军人58例58眼,术后随访6mo,统计人口学特征、致伤原因、骨折部位、手术前后视力、眼球运动、眼球突出度、手术相关情况等。结果:眶壁骨折58例均为男性。年龄P 50为21岁,多发于20~29岁(78%)。45例(78%)在军事训练中致伤,拳击伤、外物撞击伤是主要致伤原因(74%)。单纯眶内壁、下壁以及二者联合骨折是临床常见的骨折形式(91%)。所有患者术后视力较术前未见明显改变,通过术后CT与术后随访相关临床资料,未发现植入物移位、感染及其他严重并发症,33例患者眼球运动障碍得到改善,7例患者颌面部知觉异常消失,3例眼球内陷得以矫正。结论:年轻男性战士是军人眶壁骨折的主体人群,增强工作训练中的防护工作有重要意义,基层医院的基础诊治工作十分必要,手术修复治疗眶壁骨折具有显著治疗效果。

AIM:To investigate the clinical characteristics and surgical treatment fororbital wall fracture of soldiers.METHODS:This study choose 58 soldiers(58 eyes)who had surgical treatments for orbital wall fracture in our hospital from January 1 st,2015 to December 31 st,2018.Their demographic characteristics,causes of injury,fracture sites,preoperative and postoperative visual acuity,eye movement,eye prominence,and operative conditions were recorded and statistically analyzed.The patients were followed up for 6mo after treatment.RESULTS:All patients in 58 cases of orbital wall fractures were male.The P 50 age of them was 21,and most of them were 20-29 years old(78%).45 cases(78%)were injured at work,in which boxing injury and impingement injury were the main causes(74%).Simple medial orbital wall,inferior wall and both of the medial and inferior wall fractures were the common types(91%).The visual acuity of all the patients did not change significantly after operation comparing with preoperative visual acuity.According to the clinical data of postoperative CT and postoperative follow up,no implant displacement,infection or other serious complications appeared.Eye movement disorder of 33 patients were improved.Abnormal suborbital perception of 7 patients disappeared.And enophthalmos of 3 patients were corrected.CONCLUSION:Young male soldiers are the main population of orbital wall fracture.It is of great significance to improve the protection in daily training.Surgical treatment for orbital wall fractures has significant therapeutic effect.Furthermore,it is very necessary for primary hospital to develop basic diagnosis and treatment.