摘要
目的:研究不同类型的眼眶区骨折的治疗方案,探讨不同类型眼眶骨折的最佳治疗方法。方法:回顾性总结2001/2006眼眶区骨折患者共80例;按复位—眼眶—分类法分为Ⅰ～Ⅵ型,采用保守治疗和手术治疗的方法。将保守治疗无效且拒绝手术患者和接受手术的患者疗效进行比较性研究。结果:开放性骨折2例行1期手术,术后无明显复视和眼球凹陷。78例早期均先采用保守治疗,保守治疗包括使用大剂量皮质类固醇激素,高渗脱水剂、神经营养药物等,有41例复视消失或减轻,眼球内陷小于2mm,保守治疗的总有效率为52%。有37例复视、眼球内陷、眼面部畸形仍明显的患者被告知手术的必要性,其中有17例患者接受手术治疗,眼部畸形改善、复视显著改善或消失16例。20例未接受手术,眼部畸形改善、复视显著改善或消失3例。经Fisher精确率检验将两组患者疗效比较,有效率的差异有显著性。结论:对于全身情况允许的开放性骨折患者1期手术内固定可以得到良好效果;保守治疗是Ⅰ型眶区骨折的首选方法;手术内固定眶壁重建术是Ⅱ～Ⅵ型眶区骨折的较好方法。
AIM： To study the treatment plans of different type orbital fractures and to investigate the best method of every type. METHODS： Eighty cases with orbital fractures treated by conservative medical treatment or surgical treatment from 2001 to 2006 were reviewed and summarized. They were classified into six types by reduction orbital classification, The results were compared between accepting surgical treatment group and denial-of- surgical treatment group. RESULTS： Two cases which were open fractures were operated at first time. Diplopia and ocular region anomaly were not catch out. All of the 78 cases were treated by conservative treatment first. Conservative treatment was involved high doses of corticosteroid and the use of dehydrating and neurotrophy agents etc. In 41 cases （52%） diplopia completely disappeared and partly disappeared, the enophthalmos was less than 2 mm,and ocular region anomaly reduce. Thirty-seven cases （46%） whose diplopia and ocular region anomaly were not correct by conservative medical treatment were told that they must accept surgical treatment, 17 cases accepted and 20 cases disagreed. Sixteen cases was effective in surgical treatment group （17 case）,3 cases was effective in denial-ofoperation group （20 cases）.The significant difference was in the efficiency between the two groups by using FISHER accuracy inspection. CONCLUSION： Conservative medical treatment is the chief way of Ⅰ type Orbital fractures. To Ⅱ- Ⅵtype orbital fractures, surgical treatment will bring better results than conservative medical treatment. Orbital open fractures can be fixed in emergency treatment with good effect.
出处
《国际眼科杂志》
CAS
2006年第6期1450-1452,共3页
International Eye Science
关键词
眼眶区骨折
分类法
手术治疗
药物治疗
orbital fractures
classification
surgical treatment
medical treatment
