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目的:探讨采用高密度多聚乙烯(Medpor)眼眶重建联合多孔羟基磷灰石(HA)眼座植入治疗眼眶骨折眼窝凹陷的临床效果及安全性。方法:以Medpor眼眶填充联合HA眼座眶内植入治疗合并有眼眶骨折的眼窝凹陷27例。Medpor为孔径100μ的内联多孔板块状材料,分为眶底和眶缘两类。HA为孔径500μ的进口天然珊瑚羟基磷灰石。术中先行HA眼座一期或二期植入,后根据眼眶骨缺损以填充修补。结果:27例患者均获满意效果,随访6.5月可见双侧眼眶基本对称,上眶区饱满无凹陷,佩戴义眼片后患眼眼球突出度与健眼相近,患侧眶缘连续,外形良好,眶周无植入体轮廓阴影或阶梯状畸形。Medpor植入前后对眼座活动度无显著性影响。未见植入物脱出、感染、移位等并发症。结论:Medpor是一种良好的骨替代材料,具有组织相容 性好、易塑形、可血管化等诸多优点。明显优于自体组织及其他人工材料,以Medpor眼眶填充联合HA眼座眶内植入术治疗合并有眼眶骨折的眼窝凹陷为一良好术式。
Objective: To investigate the clinical effect and safety of high density polyethylene (Medpor) orbital reconstruction combined with porous hydroxyapatite (HA) ocular implantation in the treatment of orbital fractures. Methods: 27 cases of orbital depression complicated with orbital fracture were treated with Medpor orbital implantation combined with orbital implantation of HA ocular base. Medpor is a 100 μ pore size inline porous plate material, divided into orbital floor and orbital rim two types. HA is an imported natural coral hydroxyapatite with a pore size of 500μ. Intraocular lens (HA) oculomotor first or second stage implantation, followed by filling or repair of orbital bone defects. Results: All the 27 patients were satisfied with the results. At the follow-up of 6.5 months, bilateral orbital symmetry was found. The upper orbital area was full and without depression. The eyeball projection degree after wearing eyelid was similar to that of the healthy eye. The ipsilateral orbital rim was continuous, No periorbital implant shadow or step contour deformity. Medpor had no significant effect on ocular motility before and after implantation. No implant prolapse, infection, displacement and other complications. Conclusion: Medpor is a good bone substitute material with many advantages such as good histocompatibility, easy shaping and vascularization. Obviously superior to the self-organization and other artificial materials, Medpor orbital foramen combined with HA orbital implantation of orbital surgery combined with orbital fractures of the orbital recess is a good surgical procedure.