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目的 分析儿童眶壁爆裂性骨折的特点,寻求有效的治疗措施。设计 回顾性病例系列研究。研究对象 12岁 以下儿童眶壁爆裂性骨折患者59例(59眼)。方法 观察患儿眼位、眼球内陷程度、眼球运动、复视情况,通过眼眶CT观察骨 折位置、大小、肌肉嵌顿情况等。59眼中牵拉治疗5眼,行眶壁骨折整复术治疗54眼。主要指标 骨折位置,眼位,眼球内陷程 度,眼球运动,复视情况。结果 59例患者治疗前均有复视,眼球运动受限,1例眼球轻微内陷。59例眼眶CT均显示眶壁骨折, 其中眶底骨折57例,眶内壁骨折2例,眶底与眶内壁均骨折1例。牵拉治疗1-3次5例患者复视消失。整复手术治疗者于术后 8个月内复视消失,伤后1周内手术者,术后1个月内复视消失。结论 儿童眶壁骨折多发生于眶底,眼球内陷少且轻微。重度 眼球运动障碍,有直肌嵌塞者,应及早手术;手术越早(<1周),复视消失越迅速。牵拉治疗对儿童某些轻型骨折有效。
Objective To analyze the characteristics of orbital blowout fractures in children and seek effective treatment. Design retrospective case series. The study included 59 patients (59 eyes) with orbital blowout fracture under 12 years of age. Methods Ophthalmology, degree of eyeball invagination, eye movement and diplopia were observed. The fracture location, size and muscle incarceration were observed by orbital CT. 59 eyes pull the treatment of 5 eyes, line orbital fracture repair 54 eyes. The main indicators of fracture location, eye position, eye collapse, eye movement, diplopia. Results All the 59 patients had diplopia before treatment, the eye movement was limited, and 1 patient had a slight retraction. 59 cases of orbital CT showed orbital fracture, including 57 cases of orbital floor fracture, orbital wall fracture in 2 cases, orbital floor and orbital wall were 1 case of fracture. Pull the treatment 1-3 times in 5 patients disappeared diplopia. Integrative surgery in 8 months after disappearance of diplopia, surgery within 1 week after injury, diplopia disappeared within 1 month after surgery. Conclusions Orbital fractures in children often occur in the orbital floor, eye retraction less and minor. Severe eye movement disorders, who have rectal muscle implants, surgery should be as early as possible; surgery earlier (<1 week), diplopia disappeared more rapidly. Pulling therapy is effective for some light fractures in children.