眼眶爆裂性骨折的手術(shù)治療效果評(píng)估
發(fā)布時(shí)間:2018-04-02 04:20
本文選題:眼眶爆裂性骨折 切入點(diǎn):流行病學(xué) 出處:《大連醫(yī)科大學(xué)》2010年碩士論文
【摘要】: 目的:近年來隨著交通事故和工業(yè)外傷顯著增加,眼眶爆裂性骨折的發(fā)生率呈逐年上升趨勢(shì)。其中部分患者出現(xiàn)顯著復(fù)視、眼球運(yùn)動(dòng)障礙、眼球內(nèi)陷等癥狀,嚴(yán)重影響其生活質(zhì)量。鑒于眼眶結(jié)構(gòu)的復(fù)雜性和視功能的重要性,眼眶爆裂性骨折的治療一直是跨學(xué)科研究的重點(diǎn)和難點(diǎn)。眼眶骨折手術(shù)的主要目的是消除復(fù)視、改善眼球運(yùn)動(dòng)、矯正眼球內(nèi)陷和改善面中部外形。本文通過回顧調(diào)查大連醫(yī)科大學(xué)附屬第一醫(yī)院收治的眼眶爆裂性骨折患者的臨床資料,了解眼眶爆裂性骨折的流行病學(xué)特點(diǎn)。并從復(fù)視的改善程度及術(shù)后眼球運(yùn)動(dòng)功能的恢復(fù)等方面來評(píng)估眼眶爆裂性骨折患者手術(shù)治療的療效。 資料與方法: 1.對(duì)大連醫(yī)科大學(xué)附屬第一醫(yī)院2005年1月-2009年12月收治的176例眼眶爆裂性骨折患者的年齡、性別、受傷原因、伴發(fā)損傷、治療方式進(jìn)行流行病學(xué)分析。 2.對(duì)45例接受手術(shù)治療的眼眶爆裂性骨折患者進(jìn)行隨訪,將臨床檢查結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析,評(píng)價(jià)手術(shù)治療的療效。 結(jié)果: 1.眼眶爆裂性骨折男女比例為3:1,平均年齡31.5歲;交通事故傷為最主要的致傷原因,占45.81%;眶下壁為最常見的發(fā)生部位,占78%;176例眼眶爆裂性骨折患者手術(shù)治療155例,保守治療21例。 2.45例眼眶骨折中18例為單純眶壁骨折,其中15例術(shù)前有復(fù)視,13例出現(xiàn)Ⅰ級(jí)或Ⅱ級(jí)眼球運(yùn)動(dòng)障礙;術(shù)后12個(gè)月復(fù)診時(shí),僅2例殘留Ⅰ級(jí)或Ⅱ級(jí)復(fù)視,1例有Ⅰ級(jí)眼球運(yùn)動(dòng)障礙。27例復(fù)合性眼眶骨折中,其中25例術(shù)前有復(fù)視,26例發(fā)生眼球運(yùn)動(dòng)障礙;術(shù)后12個(gè)月時(shí),19例有復(fù)視(4例為Ⅲ級(jí)復(fù)視),16例有眼球運(yùn)動(dòng)障礙。 結(jié)論: 1.眼眶爆裂性骨折的主要發(fā)病人群為31-40歲的男性,交通事故為主要致傷原因;眶底骨折的發(fā)生率最高。 2.手術(shù)修復(fù)眼眶骨折能夠有效改善眼球運(yùn)動(dòng)功能和復(fù)視程度,早期手術(shù)療效優(yōu)于晚期手術(shù)。
[Abstract]:Objective: with the increase of traffic accidents and industrial injuries in recent years, the incidence of orbital blowout fracture is increasing year by year.Some of the patients showed significant diplopia, dyskinesia, enophthalmos and other symptoms, which seriously affected their quality of life.In view of the complexity of orbital structure and the importance of visual function, the treatment of orbital blowout fracture has always been the focus and difficulty of interdisciplinary research.The main purpose of orbital fracture surgery is to eliminate diplopia, improve eye movement, correct enophthalmos and improve the shape of middle face.The clinical data of orbital blowout fractures treated in the first affiliated Hospital of Dalian Medical University were retrospectively investigated to understand the epidemiological characteristics of orbital blowout fractures.The therapeutic effect of orbital blowout fracture was evaluated from the aspects of the improvement of diplopia and the recovery of eyeball movement function after operation.Information and methods:1.From January 2005 to December 2009, 176 patients with orbital blowout fracture treated in the first affiliated Hospital of Dalian Medical University were analyzed in terms of age, sex, cause of injury, accompanying injury and treatment.2.45 cases of orbital blowout fracture were followed up and the results of clinical examination were analyzed statistically to evaluate the curative effect of operation.Results:1.The male / female ratio of orbital blowout fracture was 3: 1, the average age was 31.5 years old, traffic accident injury was the main cause of injury, and the inferior orbital wall was the most common site, accounting for 155 cases of orbital blowout fracture and 21 cases of conservative treatment.2.18 of 45 cases of orbital fractures were simple orbital wall fractures, among which 15 cases had dyskinesia of grade 鈪,
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