眼球内陷

The orbital fracture may lead to many serious consequences including diplopia, enophthalmos and disturbance of ocular movement.

讨论：眼眶骨折可导致一系列并发症，包括眼球内陷、复视和眼球运动障碍，复视和眼球运动障碍与骨折移位和眼外肌嵌顿有关，骨折复位、解除嵌顿多可得到治疗，而眼球内陷的治疗则较为困难。

Orbital those who have symptoms of the disease orbital shown by the symptoms of the disease, most prominent of the eyeball and eye position to change the main, a small number of diseases can be shown enophthalmos the case.

眼窝疾病有那些症状？眼窝疾病所表现的症状，大部分是以眼球突出及眼位改变为主，少数疾病可表现出眼球内陷的情形。

Objective In order to provide early valuable information in diagnosis, prediction and treatment, the ratio between the expansion of orbital volume behind the axis of the globe and the degree of the enophthalmos was studied,and the time and degree of enophthalmos were observed.

目的：通过测量眼眶爆裂性骨折伴有眼眶扩大患者的后部眼眶容积、观察眼球内陷出现的时间及程度，研究后部眶容积扩大与眼球内陷的关系比值，为病情预测和眶内填充手术提供比较精确的参考数据。

RESULTS: Two cases which were open fractures were operated at first time. Diplopia and ocular region anomaly were not catch out. All of the 78 cases were treated by conservative treatment first. Conservative treatment was involved high doses of corticosteroid and the use of dehydrating and neurotrophy agents etc. In 41 cases（52%） diplopia completely disappeared and partly disappeared, the enophthalmos was less than 2 mm,and ocular region anomaly reduce.

结果：开放性骨折2例行1期手术，术后无明显复视和眼球凹陷。78例早期均先采用保守治疗，保守治疗包括使用大剂量皮质类固醇激素，高渗脱水剂、神经营养药物等，有41例复视消失或减轻，眼球内陷小于2mm，保守治疗的总有效率为52%。

Results:Incidence rate of restricted ocular motility, diplopia and enophthalmos were 63.2%, 62.3% and 59.6% respectively; The incidence of optic nerve injury, lacrimal injury and rupture of the globe was 15.8%, 15.8% and 12.3% respectively.

结果：眼球运动障碍、复视和眼球内陷发生率分别为63.2％、62.3％和59.6％；视神经损伤、泪道损伤和眼球破裂的发生率分别为15.8％、15.8％和12.3％。95.6％的患者接受了眶壁整复和人造骨植入术；72.8％的患者进行了骨折复位内固定术；部分患者进行了视神经减压术、眼球修补术和泪道手术。

Conclution Enophthalmos usually appeared in the second and third week, and it tended to steady until the third month. The ratio is 1.0 between the expansion of the orbital volume behind the axis of the globe and the degree of enophthalmos. The ratio measurement may predict the occurrence and the final degree of the enophthalmos , may provide precise parameter for implant's volume . It has very important clinical significance.

眼球内陷通常于伤后2周～3周出现，3个月时趋向稳定；后部眶容积增大与眼球内陷产生比值为1.0，呈正相关；后部眶容积扩大与眼球内陷比值可预测发生眼球内陷的可能性和程度，为手术矫正眼球内陷提供可靠、精确的参考，具有十分重要的临床指导意义。

Methods 96 cases were devied into early stage group (60 cases, within three weeks )and later period group(36 cases, over three weeks).In early stage group, the time and degree of enophthalmos were observed. In later period group, the orbital volume behind the axis of the globe and degree of the enophthalmos were measured. The relation between the changes of orbital volume behind the axis of the globe and the degree of the enophthalmos was assessed by using Pearson correlation coefficients.

将96例患者按发病时间分为早期病例组（60例、受伤时间1周以内）和晚期病例组（36例、受伤时间3个月以上），早期组除进行后部眼眶容积测量外，分别于1周、2周、3周测定眼球突出度（相差＞1mm为阳性），记录眼球内陷出现时间，用卡方检验进行统计学分析；晚期组测量后部眶容积增大值和眼球内陷量，对其相关性采用Pearson统计方法进行统计学分析，并得出回归方程及相关系数。

Conclution Rconstruction of the orbit and repositioning of enophthalmos of orbital fractures can obtain satisfactory result, and early repairing is better than late repairing. There is no impairment in reconstrction of the orbit and reposition of enophthalmos of orbital fractures, which is an safe and effective surgical technique.

采用人工材料行眼眶重建和眶内充填技术手术治疗眼球内陷可获得满意的疗效，早期手术效果优于晚期手术，手术创伤对视功能无明显影响，眼眶重建和眼球复位手术是安全可行的。

Results In early stage group, 5 of 60 cases appeared enophthalmos in first week(8.33%), 48(80%)cases appeared in second week, 53(88.33%)cases appeared in third week. No significant difference was found in second week and third week（χ2＝1.563, P＜0.001. There were significant difference between the first week and second week（χ2＝62.484,P＜0.001 ,the first week and third week（χ2＝76.885,P＜0.001）. There was significant linear correlation between expansion of the orbital volume behind the axis of the globe and the degree of enophthalmos（r=0.994,P＜0.001,with each 1.0ml expansion in the orbital volume behind the axis of the globe causing approximately 1.0mm enophthalmos.

结果：早期组60例患者中，5（8.33%）例患者在1周内出现眼球内陷，48（80%）例在2周内出现内陷， 3周时有53（88.33%）例呈现出内陷；2周时出现眼球内陷的例数与1周时有显著性差异（χ2＝62.484， P＜0.001），2周时出现眼球内陷例数与3周时无差异（χ2＝1.563， P＞0.05），1周时出现眼球内陷例数与3周时有显著差异（χ2＝76.885，P＜0.001），后部眶容积增大与眼球内陷的比值约为1.0，两者之间呈正相关（r=0.994，P＜0.001），即后部眶容积每增加1ml，产生1.0mm的眼球内陷。

We had not found any serious complications happened in both the two groups. For the CAD treatment group, the average degree of enophthalmos is 4.4 mm, and the average number of area appearing diplopia is 4, the numbers decreased to 2.4 mm and 2.5 postoperatively respectively. For the control group, the numbers are 3.75mm and 2.1 preoperatively, 1.17mm and 1.1 postoperatively.

所有病例均未出现感染、移位和眼球运动障碍等并发症，CAD/CAM治疗组术前平均眼球内陷为4.4mm，复视区域4个，术后分别为2.4mm和2.5个，非CAD/CAM组术前平均眼球内陷为3.75mm，复视区域2.1个，术后分别为1.17mm和1.1个。

It has been put forward that there exists single Ball point and double Ball points on the symmetrical connecting-rod curves of equilateral mechanisms.

从鲍尔点的形成原理出发，分析对称连杆曲线上鲍尔点的产生条件，提出等边机构的对称连杆曲线上有单鲍尔点和双鲍尔点。

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