[1]李志强,刘桂琴,祝天辉,等.伴或不伴下直肌箝闭的trapdoor眼眶骨折的临床特征[J].眼科新进展,2016,36(10):953-956.[doi:10.13389/j.cnki.rao.2016.0255]
　LI Zhi-Qiang,LIU Gui-Qin,ZHU Tian-Hui,et al.Clinical features of orbital-floor trapdoor fracture with or without inferior rectus muscle incarceration[J].Recent Advances in Ophthalmology,2016,36(10):953-956.[doi:10.13389/j.cnki.rao.2016.0255]
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伴或不伴下直肌箝闭的trapdoor眼眶骨折的临床特征
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
36卷
期数:
2016年10期
页码:
953-956
栏目:
应用研究
出版日期:
2016-10-05

文章信息/Info

Title:
Clinical features of orbital-floor trapdoor fracture with or without inferior rectus muscle incarceration
作者:
李志强; 刘桂琴; 祝天辉; 马大卉; 欧阳明
514031　广东省梅州市，梅州市深梅眼科医院（李志强）；518040　广东省深圳市，深圳市眼科医院，深圳眼科学重点实验室，深圳大学眼视光学院（刘桂琴，祝天辉，马大卉，欧阳明）
Author(s):
LI Zhi-Qiang ;  LIU Gui-Qin ; ZHU Tian-Hui; MA Da-Hui; OU-YANG Ming
Shenmei Eye Hospital ( LI Zhi-Qiang) , Meizhou 514031 , Guangdong Province , China ; Shenzhen Eye Hospital , Shenzhen Laboratory of Ophthalmology, Shenzhen Eye Hospital of Shenzhen University ( LIU Gui-Qin , ZHU Tian-Hui, MA Da-Hui, OU-YANC Ming ) , Shenzhen 518040, Guangdong Province , China
关键词:
trapdoor眼眶骨折; 眼眶骨折; 爆裂性眼眶骨折; 儿童; 临床特征
Keywords:
orbital trapdoor fractures ;  orbital fractures ;  orbital blowout fractures ;  children ;  clinical feature
分类号:
Ｒ７７７.５
DOI:
10.13389/j.cnki.rao.2016.0255
文献标志码:
A
摘要:
目的　研究伴或不伴有下直肌箝闭的ｔｒａｐｄｏｏｒ眶底骨折的临床特征。方法　回顾性分析２００８年１月至２０１５年１２月在深圳市眼科医院确诊为ｔｒａｐｄｏｏｒ眶底骨折并行眼眶壁骨折整复术的２０例儿童和青年患者的临床资料，根据ＣＴ图像和术中所见将患者分为两组：伴或不伴有下直肌箝闭组。对两组术前术后的症状、ＣＴ图像、手术记录和随访结果进行比较。结果　不伴下直肌箝闭组的年龄、就诊时间和手术时间分别为（８．９１±５．３２）岁、（７．６４±８．２４）ｄ、（９．００±８．３９）ｄ，伴下直肌箝闭组分别为（１２．４４±４．６９）岁、（９．５６±６．６２）ｄ、（１０．７８±６．４４）ｄ，两组相比差异均无统计学意义（均为Ｐ＞０．０５）。但伴有下直肌箝闭的ｔｒａｐｄｏｏｒ眼眶骨折表现为严重的眼球上转受限－３．８９±０．３３、明显下转受限－２．４４±０．７３和严重的被动上转受限－４。而不伴有下直肌箝闭者表现为轻至中度上转受限－１．９１±０．３０、轻度被动上转受限－１．０９±０．３０。除了伴或不伴有下直肌箝闭外，二组其他ＣＴ图像相似。结论　伴有严重的眼球上转受限、中度及以上眼球下转受限，及严重的被动上转受限的ｔｒａｐｄｏｏｒ眼眶骨折提示有下直肌箝闭。轻至中度眼球上转受限和轻度被动上转受限，下转无明显受限者提示仅为脂肪结缔组织嵌顿。
Abstract:
Objective To study the clinical features of orbital-floor trapdoor fracture with or without inferior rectus muscle incarceration. Methods This was a retrospective review study. From January 2008 to December 2015 .20 children and adolescents with orbital-floor trapdoor fracture were seen in Shenzhen Eye Hospital. The patients were classified into two groups , trapdoor fracture with or without muscle incarceration , according to computed tomography ( CT) images and intraoperative findings. Pre- and post-operative signs and symptoms , CT images ,intraoperative findings and follow-up results of the two groups were compared. Results The mean age , interval to presentation. and interval to surgery of patients without muscle incarceration were ( 8. 91 +5. 32) days , ( 7. 64 + 8. 24 ) days , and ( 9. 00 + 8. 39 ) days , patients with muscle incarceration were ( 12. 44 + 4. 69) days , ( 9. 56 + 6. 62 ) days , and ( 10. 78 + 6. 44 ) days , respectively,there was no significant difference between the two groups ( all P > 0. 05 ) . Trapdoor fracture with muscle incarceration showed more severe motility restriction in up gaze - 3. 89 + 0. 33 and moderate motility restriction in down gaze - 2. 44 + 0. 73 . marked linutation to sursumduction - 4 ,whereas fracture without muscle incarceration showed mild to moderate motility restriction in up gaze - 1. 91 + 0. 30 .mild limitation to sursumduction - 1. 09 +0. 30 .no motility restriction in down gaze. The other CT images were similar between two groups except with or without muscle incarceration. Conclusion Orbital trapdoor fracture patients with severe motility restriction in up gaze and moderate or higher motility restriction in down gaze , plus marked limitation to sursumduction are suggested to have inferior rectus muscle incarceration, with mild to moderate motility restriction in up gaze , mild limitation to sursumduction . Nno obvious motility restriction in down gaze are suggested to have connective tissue septa entraped only.

相似文献/References:

[1]张沧霞,郑艳霞,王义军,等. 眼眶骨折168例临床分析[J].眼科新进展,2014,34(9):849.[doi:10.13389/j.cnki.rao.2014.0234]
[2]季中锟,赵云,于莎莎,等.眼眶爆裂性骨折修复手术模拟的眼眶3D打印模型和外科种植体模型的研究[J].眼科新进展,2017,37(7):662.[doi:10.13389/j.cnki.rao.2017.0168]
　JI Zhong-Kun,ZHAO Yun,YU Sha-Sha,et al.Application of 3D printing orbit and surgical implant for orbital blowout fracture surgical operation planning and teaching[J].Recent Advances in Ophthalmology,2017,37(10):662.[doi:10.13389/j.cnki.rao.2017.0168]

更新日期/Last Update: 2016-10-25