眼眶爆裂性骨折的手术治疗效果评估

发布时间：2018-04-02 04:20

  本文选题：眼眶爆裂性骨折　切入点：流行病学　出处：《大连医科大学》2010年硕士论文

【摘要】： 目的：近年来随着交通事故和工业外伤显著增加,眼眶爆裂性骨折的发生率呈逐年上升趋势。其中部分患者出现显著复视、眼球运动障碍、眼球内陷等症状,严重影响其生活质量。鉴于眼眶结构的复杂性和视功能的重要性,眼眶爆裂性骨折的治疗一直是跨学科研究的重点和难点。眼眶骨折手术的主要目的是消除复视、改善眼球运动、矫正眼球内陷和改善面中部外形。本文通过回顾调查大连医科大学附属第一医院收治的眼眶爆裂性骨折患者的临床资料,了解眼眶爆裂性骨折的流行病学特点。并从复视的改善程度及术后眼球运动功能的恢复等方面来评估眼眶爆裂性骨折患者手术治疗的疗效。 资料与方法： 1.对大连医科大学附属第一医院2005年1月-2009年12月收治的176例眼眶爆裂性骨折患者的年龄、性别、受伤原因、伴发损伤、治疗方式进行流行病学分析。 2.对45例接受手术治疗的眼眶爆裂性骨折患者进行随访,将临床检查结果进行统计学分析,评价手术治疗的疗效。 结果： 1.眼眶爆裂性骨折男女比例为3：1,平均年龄31.5岁；交通事故伤为最主要的致伤原因,占45.81%；眶下壁为最常见的发生部位,占78%；176例眼眶爆裂性骨折患者手术治疗155例,保守治疗21例。 2.45例眼眶骨折中18例为单纯眶壁骨折,其中15例术前有复视,13例出现Ⅰ级或Ⅱ级眼球运动障碍；术后12个月复诊时,仅2例残留Ⅰ级或Ⅱ级复视,1例有Ⅰ级眼球运动障碍。27例复合性眼眶骨折中,其中25例术前有复视,26例发生眼球运动障碍；术后12个月时,19例有复视(4例为Ⅲ级复视),16例有眼球运动障碍。 结论： 1.眼眶爆裂性骨折的主要发病人群为31-40岁的男性,交通事故为主要致伤原因；眶底骨折的发生率最高。 2.手术修复眼眶骨折能够有效改善眼球运动功能和复视程度,早期手术疗效优于晚期手术。
[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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