儿童眼眶爆裂性骨折的临床治疗
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Treatment for pediatric orbital blowout fracture
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    摘要:

    目的:探讨儿童眼眶爆裂性骨折的临床表现及治疗方法。

    方法:选取2008-03/2010-10儿童眼眶爆裂性骨折患儿12例12眼,分析其临床表现,并早期进行手术治疗。

    结果:患者12例大部分为摔伤后出现眼下壁骨折、下直肌嵌顿,表现为复视,CT表现为“泪滴征”。12例均早期实施手术。手术后12例复视均明显改善。其中6例于术后1wk上转逐渐恢复到位; 4例于术后3mo内恢复; 2例6mo内仍有上转不到位,其牵拉试验为阳性。

    结论:儿童爆裂性骨折多表现为下壁的裂隙性骨折,表现为眼球运动受限和复视,眼球内陷少见; 外伤及手术都容易造成肌肉损伤,早期手术治疗对于肌肉功能的恢复有重要意义。

    Abstract:

    AIM: To analysis the mechanism, clinical peculiarity, and treatment for pediatric orbital blowout fracture.

    METHODS: The retrospective analysis included 12 pediatric patients suffered from orbital blowout fracture from 2008-2010.

    RESULTS: Of the 12 pediatric patients, most of the orbital blowout fractures were located in orbital floor when the patients fell over. Diplopia occurred and embedded musculi were observed by CT. Early interventions were taken. Diplopia improved in all of the 12 pediatric patients. One week after surgery, eye movements in 6 patients became normal gradually; 4 patients' muscle recuperated in 3 months; 2 patients couldn't move their eyes normally within 6 months and traction tests were positive.

    CONCLUSION: The pediatric orbital blowout fracture more often happen in floor orbital and cranny blowout is their configuration. Restricted movement and diplopia are main signs. Enophthalmos occurs rarely. Trauma and operation both can cause muscle's hurt. Early intervention usually led to better improvement and more complete resolution of ocular motility limitation and diplopia than late repairs.

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王树纲,刘宗明,张繁友.儿童眼眶爆裂性骨折的临床治疗.国际眼科杂志, 2012,12(10):2020-2021.

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  • 收稿日期:2012-04-20
  • 最后修改日期:2012-09-01
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