目的 讨论外伤性直肌离断的早期手术方法及治疗效果。 方法 打开直肌离断侧的结膜与Tenon氏囊,暴露肌肉附着点,沿两侧肌间膜寻找丢失的断端,行端端吻合。找寻断端失败者,可将近附着点端与远端肌间膜及肌鞘缝合,以达到修复的目的。结果 5例直肌离断者3例行端端吻合,2例行断端与肌鞘肌间膜吻合,术后眼球运动恢复,复视消失。结论 对于直肌离断者宜早期进行正确的手术修复,术中解剖结构清晰,操作仔细,避免继发损伤,尽量进行断端吻合,若断端寻找失败,可利用邻近的肌间膜作支架,使复视消失,眼球运动恢复正常,利于肌肉修复,是手术成功的关键。 Objective To discuss the early surgical treatment of traumatic rectus abdominis and its therapeutic effect. Methods The conjunctiva and Tenon ’s capsule in the rectus abdominis were opened and the muscle attachment sites were exposed. Finding the failure of the stump side, near the point of attachment and distal myometrial and muscular sheath suture, in order to achieve the purpose of repair. Results In 5 cases of rectus abdominis, 3 cases got end-to-end anastomosis, 2 cases performed end-to-end anastomosis with muscular-muscular myenteric anastomosis, and the oculomotor recovery and diplopia disappeared after operation. Conclusion For the patients with rectus abdominis, the correct operation should be performed early, the anatomy is clear, the operation is careful, the secondary injury should be avoided, the anastomosis should be done as far as possible, and the adjacent intermuscular membrane can be used as the scaffold , So diplopia disappeared, eye movements returned to normal, which will help muscle repair, the key to the success of surgery.