司法鉴定的眼外伤眼眶爆裂性骨折的临床决策
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摘要
研究分析涉及司法鉴定的眼部钝力伤致眼眶爆裂性骨折临床决策的特殊性,依据医学原理,做出有益于伤者康复及纠纷解决的决策。选取眼眶爆裂性骨折49例(49眼)。其中内侧壁骨折30例,下壁骨折19例。致伤原因:斗殴25例,交通肇事17例,运动伤5例,自己意外伤2例。30例2周内接受手术治疗,眼球运动不受限,眼位满意,功能位无复视,2例特定方位复视,3个月后消失。19例拒不接受手术治疗,3个月后眼球不同程度内陷,16例功能位复视,眼球转动疼痛。眼眶骨折早期手术治疗预后佳,后患少,对受伤者及肇事者均有益。
Research and analyze the specifieness of clinical decision making on orbital blowout fracture from blunt forced ocular traumas involving judicial identification.Make decisions beneficial to recovery of the injured and dispute resolution according to the medical principles.Orbital blowout fracture 49 cases(49 eyes).Among them inside wall fracture in 30 cases,inferior wall fracture in 19 cases.Causes of injury: fighting in 25 cases,traffic accident in 17 cases,5 cases of sports injuries,oneself accidental injury in 2 cases.Surgery performed on 30 cases within 2 weeks.Eyeball movement is not restricted with satisfactory eye position,and without diplopia in the functioning position.2 cases with diplopia in specific direction but disappeared after 3 months.Different degree of enophthalmos happened after 3 months to 19 cases not acceptable to surgery treatment,among those 16 cases with diplopia in functioning position and eyeball movement pain.Good effect could be achieved with little future troubles if early surgery treatment performed for orbital fracture.It shall be beneficial to both injured and perpetrators.
Research and analyze the specifieness of clinical decision making on orbital blowout fracture from blunt forced ocular traumas involving judicial identification.Make decisions beneficial to recovery of the injured and dispute resolution according to the medical principles.Orbital blowout fracture 49 cases(49 eyes).Among them inside wall fracture in 30 cases,inferior wall fracture in 19 cases.Causes of injury: fighting in 25 cases,traffic accident in 17 cases,5 cases of sports injuries,oneself accidental injury in 2 cases.Surgery performed on 30 cases within 2 weeks.Eyeball movement is not restricted with satisfactory eye position,and without diplopia in the functioning position.2 cases with diplopia in specific direction but disappeared after 3 months.Different degree of enophthalmos happened after 3 months to 19 cases not acceptable to surgery treatment,among those 16 cases with diplopia in functioning position and eyeball movement pain.Good effect could be achieved with little future troubles if early surgery treatment performed for orbital fracture.It shall be beneficial to both injured and perpetrators.
引文
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[2]Chang S H,Philip L C,Yasaman M,et al.Use of Lorenz titaniumimplants in orbital fracture repair[J].Ophthal Reconstr Surg,2009,25(2):119-122.
[3]李伦昊,肖彩霞,范先群.钛合金材料在眼眶骨缺损修复中的应用[J].中国实用眼科杂志,2011,19(5):432-434.
[4]杨秉辉.临床决策的立场[J].医学与哲学:临床决策论坛版,2009,30(6):2-3.
[5]赵芹芳,李万海,郭庆生.眶下壁骨折误诊上颌窦息肉一例[J].中国实用眼科杂志,2011,29(4):411.
[6]杜治政.论新的医学人文观[J].医学与哲学:人文社会医学版,2008,29(7):8-14.