眼眶骨折诊疗中的几个关键问题及其对策

The several key problems and solutions in the diagnosis and treatment of orbital fracture

目的探讨眼眶骨折诊断和治疗中的几个关键问题,并有针对性的采取不同的应对措施。方法回顾分析眼眶骨折198例,所有病例均行眼眶水平结合冠状CT检查,12例行三维重建技术证实诊断;其中64例保守治疗,134例行手术治疗。结果64例保守治疗病例中眼球内陷无明显改善,复视和眼球运动障碍均得到改善;134例手术治疗病例中,54例眼外肌粘连或嵌塞均矫正满意,12例张口及咬合受限均矫正满意;81.34%的眼球内陷术后矫正满意,但8例出现术后并发症。结论CT是眼眶骨折诊断的金标准,根据病情程度采取不同的治疗方式。

Objective To study the several key problems and solutions of the orbital fracture in diagnosis and treatment.Methods The clinical data of 198 cases of orbital fracture were analyzed retrospectively.All the patients had CT scan,and the images of 12 cases of were treated using the software to acquire the three-dimensional reconstruction images.Among 198 cases of patients,64 cases had conservative treatment,134 cases had surgical treatment.Results Among 64 cases of conservative treatment,the enophthalmos had no significant improvement,but all the diplopia and the ocular motility disorder had significant improvement;Among 134 cases of surgical treatment,the adhesion and impaction of the ocular muscle in 54 cases were corrected satisfactorily,the limitation of mouth opening and occlusion in 12 cases were corrected satisfactorily,the enophthalmos of 81.34%were corrected unsatisfactorily,but 8 cases had postoperative complications.Conclusions The CT scan is a gold standard,the treatment methods and the surgical operation must be strictly used according to the condition of the disease.