中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2026, Vol. 24 ›› Issue (5): 488-493.doi: 10.19438/j.cjoms.2026.05.008

• 论著 • 上一篇    下一篇

术中CT在眶壁骨折治疗中的应用效果评价

李艾珑1,2, 仇清源1,2, 庞超远1   

  1. 1.联勤保障部队第九四医院 口腔颌面外科,甘肃 兰州 730050;
    2.兰州大学口腔医学院,甘肃 兰州 730013
  • 收稿日期:2025-09-30 修回日期:2026-03-13 出版日期:2026-09-20 发布日期:2026-10-10
  • 通讯作者: 庞超远,E-mail: pcyfmmu@163.com
  • 作者简介:李艾珑（2002—）,男,在读硕士研究生,E-mail: lial2024@lzu.edu.cn
  • 基金资助:
    中华口腔医学会口腔健康促进与口腔医学发展西部临床科研基金项目（CSA-W2023-5）

Evaluation of the application effect of intraoperative CT in the treatment of orbital wall fractures

Li Ailong1,2, Qiu Qingyuan1,2, Pang Chaoyuan1   

  1. 1. Department of Oral and Maxillofacial Surgery, The 940th Hospital of Joint Logistics Support Force of PLA. Lanzhou 730050;
    2. Department of Oral and Maxillofacial Surgery, School of Stomatology, Lanzhou University. Lanzhou 730013, Gansu Province, China
  • Received:2025-09-30 Revised:2026-03-13 Online:2026-09-20 Published:2026-10-10

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摘要： 目的：探讨术中计算机体层扫描（intraoperative computed tomography,iCT）在眶壁骨折修复手术中的应用价值。方法：选取2023年7月—2025年7月联勤保障部队第九四医院收治的单侧眶壁骨折患者28例,随机分为术中CT组（14例）和传统手术组（14例）。术中CT组在关闭伤口前使用iCT扫描（层厚0.625 mm）,评估骨折复位及植入物位置,若复位不良即刻调整;传统组依赖经验完成手术。术后比较两组手术时间、并发症发生率、眼球内陷改善值、眼眶容积差等指标。结果：患者以男性为主（75.0%）,平均32.7岁,交通事故为主要致伤原因（35.7%）,左侧骨折多见（60.7%）,颧骨复合体伴眶周骨折占82.1%。术中CT组50%的患者术中调整复位,术后6个月眼球内陷改善[(2.7±1.4) mm]及眼眶容积差[(997.9±445.6) mm3]均优于传统组,且无复视加重病例。结论：术中CT可实时精准评估眶壁骨折复位效果,显著改善术后眼眶容积对称性及眼球内陷矫正效果,降低复视加重风险,对提升复杂眶壁骨折修复的精准性具有一定的临床价值。

关键词: 术中CT, 眼眶骨折, 爆裂性骨折, 眼眶容积

Abstract: PURPOSE: To investigate the application value of intraoperative computed tomography (iCT) in the surgical repair of orbital wall fractures. METHODS: Twenty-eight patients with unilateral orbital wall fractures admitted at the 940th Hospital of Joint Logistics Support Force of PLA from July 2023 to July 2025 were enrolled and randomly divided into the iCT group (n=14) and the conventional group (n=14). In the iCT group, iCT scanning (slice thickness: 0.625 mm) was performed before wound closure to evaluate fracture reduction and implant position; immediate adjustment was carried out in case of malreduction. The conventional group underwent surgery solely based on the surgeons' experience. Postoperative comparisons between the two groups included operation time, complication rate, improvement in enophthalmos, and orbital volume difference. RESULTS: The cohort was predominantly male (75.0%), with a mean age of 32.7 years. Road traffic accidents were the leading etiology (35.7%). Left-sided fractures were more common (60.7%), and zygomaticomaxillary complex fractures with periorbital involvement constituted 82.1% of the cases. Intraoperative adjustments based on iCT findings were required in 50% of the iCT group patients. At 6 months postoperatively, the improvement in enophthalmos [(2.7±1.4) mm] and the orbital volume difference [(997.9±445.6) mm3] in the iCT group were both superior to those in the traditional group, with no exacerbation of diplopia observed. CONCLUSIONS: Intraoperative CT enables real-time and accurate evaluation of orbital wall fracture reduction. It significantly improves postoperative orbital volume symmetry and enophthalmos correction, reduces the risk of aggravated diplopia, and has important clinical significance for enhancing the precision of complex orbital wall fracture repair.

Key words: Intraoperative CT, Orbital fractures, Blowout fractures, Orbital volume

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