爆裂性眶下壁骨折合并视神经撕脱伤临床较少见,我科收治1例,现报告发下:程×,男,33岁,住院号252892,右眼铁块击中后视物不见半小时,于1998年6月2日急诊入院.眼科检查:视力右无光感,左1.0,右眼下睑自内眦向颞下弧形裂开,伤口大约50mm,污浊,深达骨壁,伤口内有两块碎骨片,上颌骨轻度内陷骨折,球结膜充血,下方有小裂口,并有污物附着,角膜清,瞳孔散大,玻璃体浑浊.眼底检查见视盘区被大片出血遮盖,视网膜弥漫性灰白色水肿,仅见数条变细血管.CT报告:右侧上颌窦腔内显高密度影.诊断:睑皮肤裂伤,爆裂性眶下壁骨折,视神经撕脱.入院后立即行皮肤裂伤清创缝合术,术后肌注TAT及止血敏,并予抗生素抗感染,口服维生素C、E、地巴唑、肌苷、强的松,并加用神经营养药三磷酸腺苷、辅酶A;术后第3天,拆除纱布后包扎.7天时皮肤伤口期愈合,视力右无光感,1月复查,右眼上睑遮盖角膜上1/2,眼球上转受限,左/右约5°～10°.眼底见视盘呈深井状 Bursting suborbital foramen fractures associated with optic nerve avulsion injury clinical less common in our department admitted 1 case, the report is issued under: Cheng ×, male, 33 years old, hospital number 252892, the right eye iron hits hit the back half of the sight to see half Hour and was admitted to the emergency department on June 2, 1998. Ophthalmology examination: the right eye without light perception, the left 1.0, the right eyelid from the infraorbital to the infratemporal arcuate rupture, the wound about 50mm, dirty, as deep as the bone wall, the wound There are two pieces of bone fragments, the maxillary minimally invasive fracture, conjunctival congestion, there is a small gap below, and dirt attached to the cornea clear, mydriasis, vitreous opacity. , Retinal diffuse gray edema, only a few thinning blood vessels .CT report: the right side of the maxillary sinus was high-density shadow. Diagnosis: eyelid skin laceration, burst orbital wall fractures, avulsion of the optic nerve. Immediately after admission Skin dehiscence and debridement surgery, postoperative intramuscular injection of TAT and hemostatic sensitivity, and to antibiotics anti-infective, oral vitamin C, E, and barredazole, inosine, prednisone, and add neurotrophic adenosine triphosphate, coenzyme A ; 3 days after surgery, gauze removed after bandaging .7 days when the skin wound healing, visual acuity no light, review in January, the right eye upper eyelid cover Corneal 1/2 turn constrained, left / right about 5 ° ~ 10 ° on the eye fundus optic disc was deep shape See