眼眶爆裂性骨折年龄因素与临床及影像学特点分析

目的 分析比较青少年和成年人眼眶爆裂性骨折(BOF)的临床、影像学特点及临床与影像学表现的相关性,以利于评估预后以及制定准确合理的治疗方案.方法 收集2006年10月至2008年12月住院且接受手术治疗、临床及影像学资料的BOF患者75例,分为青少年组(≤18岁,20例)和成年组(19～56岁,55例).总结其病史、临床、影像学特点及手术所见并进行统计学分析.结果 青少年组致伤原因主要为摔伤和拳击伤,其次为车祸、撞伤等,成年组致伤原因主要为拳击伤和车祸,其次为硬物击伤、摔伤等;两组之间性别及眼别构成比差别无统计学意义(P>0.05);青少年组术前双眼眼球突出度差值小于成年组(P<0.05);青少年组伤后出现恶心、呕吐症状的构成比高于成年组(P<0.05);两组受累眶壁之间的构成比差别有统计学意义(P<0.05);青少年组骨折区呈裂缝状或阀门样表现的构成比高于成年组(P<0.05);青少年组发生肌肉嵌夹的构成比高于成年组(P<0.05);青少年组手术见肌肉呈深紫色改变的构成比高于成年组(P<0.05).结论 青少年及成年人BOF的临床及影像学特点存在明显差异,结合临床及影像学特点综合分析对于评估患者病情及预后,及时准确地制定治疗方案有较大意义.

The correlation analysis among age and clinical and imageological characteristics for orbital blow-out fractures

Objective To analyze and compare the clinical and imageological characteristics of or- bital blow-out fractures between juvenile and adult,and analyze the correlation between clinical manifestations and imageological characteristics.Help the clinicians to analyze patients,conditions roundly and carefully and make reasonable treatment proposals.Methods Collected 75 patients with isolated orbital blow-out fracture whom clinical and imageological materials were completed from October 2006 to December 2008.All patients were divided into two groups:juvenile (≤18 years old,20 Cases) and adult (19-56 years old,55 cases).The ill history,clinical and imageological characteristics and the operative findings of all the cases were summarized. Meanwhile.statistical analysis was made.Results The main:reasons of orbital fractures were fall and violence in juvenile group and that in adult group were vehicle accident and violence.The difference of constituent ratio about gender and involved eyes between two groups had no statistical significance(P>0.05).The severity of enophthalmos in juvenile group was lower than in adult group (P<0.05).The constituent ratio of nauseavomit after being hurt,linear or trapdoor type fracture,muscle incarceration as well as muscle congestion were higher. in juvenile group than in adult group (P<0.05).The difference of constituent ratio about involved orbital floors between two groups had statistical significance (P<0.05).There was no difference of simple medial wall fracture between two groups (P<0.05).Conclusions There are obvious differences between juvenile and adult orbital blow-out fractures in clinical and imageological characteristics.They all have their own special features,by the combination of clinic and imageology,we can evaluate the patients,condition exactly and make reason- able treatment proposals in time.