可吸收眶底板在眼眶骨折手术中的应用
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Clinical application of resorbable plate in orbital fracture surgery
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    摘要:

    目的:评价可吸收眶底板在眼眶骨折修复手术中的临床应用效果。

    方法:回顾性分析眼眶骨折患者48例48眼的临床资料,所有患者均采用可吸收眶底板进行眼眶骨折修复,术中充分暴露骨折缺损范围后还纳疝出的眶内组织,根据缺损范围塑形可吸收眶底板,植入眶内并以可吸收螺钉固定。手术前后通过眼部检查和眼眶CT扫描评价可吸收眶底板在眼眶骨折修复手术中应用的可行性和精确性。

    结果:本组患者均顺利完成手术,均未出现严重的并发症,CT扫描可见眼眶骨折均得到良好的解剖复位。术后1a复查,术前18眼眼球运动障碍患者中1眼好转(6%),17眼治愈(94%); 术前30例复视患者中12例好转(40%),18例治愈(60%); 术前32眼眼球凹陷患者中10眼好转(31%),22眼治愈(69%); 术前40眼眶下神经分布区麻木患者中33眼好转(82%),7眼治愈(18%)。本组患者中1眼术前出现下睑内翻、倒睫,术后得以恢复。

    结论:可吸收眶底板在眶壁骨折修复术中应用效果良好,是一种较好的眼眶修复材料。

    Abstract:

    AIM: To evaluate the clinical application of resorbable implants in orbital fracture repair surgery.

    METHODS: A retrospective analysis of 48 eyes in 48 cases of orbital fracture, all patients were treated with resorbable implants for orbital fracture repair. During operations we exposed fully fracture defect range and returned the tissues that entered the paranasal sinus. A resorbable implant was trimmed to proper sizes according to the fracture defect range and fixed with 2 absorbable screws. The accuracy of plate positioning of the reconstructed orbit and the practicability of clinical use of resorbable implant were judged by the ophthalmic examination and computed tomography(CT)scan before and after operation.

    RESULTS: All the patients completed the operation successfully and had no serious complications during or after surgery. All the patients had a good anatomical restoration by the postoperative CT scan. One year re-examination after operation, among 18 eyes with limitation of extraocular muscle movement(EOM)before operation 1 eye(6%)with limitation of EOM improved after surgery,17 eyes(94%)with limitation of EOM got cured. Among 30 cases with diplopia before operation 12 cases(40%)with diplopia improved after surgery, 18 cases(60%)with diplopia got cured. Among 32 eyes with enophthalmos before operation 10 eyes(31%)with enophthalmos improved after surgery, 22 eyes(69%)with enophthalmos get cured. Among 40 eyes with suborbital skin numbness before operation 33 eyes(82%)with suborbital skin numbness improved after surgery, 7 eyes(18%)with suborbital skin numbness got cured. Only one eye got lower eyelid entropion after surgery and was resolved by the second correction of entropion.

    CONCLUSION: The resorbable implant can repair the fractures of orbital wall well. It is a better material of orbital fracture repairment.

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刘伟,刘韶瑞,施沃栋,等.可吸收眶底板在眼眶骨折手术中的应用.国际眼科杂志, 2020,20(1):181-185.

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  • 收稿日期:2019-07-18
  • 最后修改日期:2019-12-05
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  • 在线发布日期: 2019-12-20
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