经内侧结膜入路修复眶内侧壁骨折临床分析
眶骨折,,眶骨折；结膜入路；眼眶手术,1资料与方法,2结果,3讨论,【参考文献】
【摘要】 目的 探讨经内侧结膜入路修复眶内侧壁骨折的手术安全性和可行性。方法 对2000年1月～2004年1月收治的42例(42眼)眼眶内侧壁骨折患者的临床资料进行回顾性分析，包括单纯内壁、复合内壁和下壁骨折的类型。男30例，女12例，年龄15～56岁，平均30岁。术后眼眶内陷程度≤2mm，以无复视作为修复成功的标准。结果 所有修复手术均一次成功，随访5～24个月(平均9.2个月)，术后24眼未出现眼球内陷，16眼眼球内陷程度在0.5～1.0mm之间，2眼眼球内陷程度达1.5mm，术后未有临床意义的眼球内陷程度≥2mm者出现。术后只有4眼视近时有复视，38眼(90.48%)无复视。结论 经内侧结膜入路为修复单纯的眼眶内侧壁骨折提供了一个安全可行的手术方法。如果合并下侧壁骨折可经下结膜入路，可成功完成复合的内侧、下侧眼眶壁骨折的手术修复。【关键词】 眶骨折；结膜入路；眼眶手术
Repairing the medial orbital wall fracture with medial transconjunctival approach
CHEN Jin-chang,DONG Xiao-ming,LI Yu-zhen,et al.
The Second Peoples Hospital of Jingdezhen,Jingdezhen 333000,China
【Abstract】 Objective To explore a safe and feasible surgical approach for repairing the medial orbital wall fracture,with the medial transconjunctival approach.Methods From January 2000 to January 2004,42 consecutive patients (42 eyes),with the diagnosis of medial orbital wall fracture were retrospectively evaluated,42 consecutive patients with a isolated medial or a combined medial and inferior orbital wall fracture.30 men and 12 women,the patient ages ranged from 15 to 56 years old (mean 30 years old),postoperation,surgical success was defined as enophthalmos≤2mm and no diplopia.Results All operations were succeed by only one time.The patients were followedup for 5 to 24 months(mean 9.2 months).Postoperatively,24 patients showed no enophthalmos,the enophthalmos ranged from 0.5～1.0mm in 16 patients and 1.5mm enphthalmos was noted in 2 patients.A clinically significant enophthalmos≥2mm was not found,only 4 patients had diplopia with looking close shot.38 patients showed no diplopia.Conclusion The medial transconjunctival approach provides a safe and feasible surgical approach for managing a isolated medial wall fracture.When combined with the inferior transconjunctival approach,a combined medial and inferior orbital wall fracture can be successfully repaired. ......
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