摘要目的 探讨Hess屏面积比(HAR％)在评估眶底爆裂性骨折患者术后复视的预后价值.方法 眶底爆裂性骨折19例,手术前均有复视,18例于外伤后1个月内行眶底骨折整复手术,手术由同一术者施行,采用经下睑睫毛下切口.于手术前和手术后3个月分别进行Hess屏检查计算HAR％,并记录复视的程度.结果 各组患者的手术前和手术后的HAR％差异具有统计学意义(P＜0.05).在手术后3个月,术前HAR％＞85％的患者在眶壁骨折整复术后没有复视；术前HAR％＜65％的患者5例(83.33％)术后有复视,其中3例(50％)是Ⅲ级复视；HAR％介于65％和85％之间的患者中6例(75％)术后有复视,其中1例(12.50％)是Ⅲ级复视.结论 HAR％是将Hess屏的图表形式转换为数字形式的有效方式,可以用来预测眶底爆裂性骨折患者术后复视的预后.

abstractsObjective To investigate the value of the Hess area ratio (HAR％) in predicting postoperative diplopia in patients undergoing surgery for orbital floor blowout fracture.Methods A retrospective analysis was performed on 19 patients with orbital floor blow-out fractures.All patients had diplopia and underwent surgical reconstruction with incision under the eyelashes which was performed by one surgeon within 1 month after injury except 1 case within 2 month.Manual Hess screen test was measured before and 3 months after surgery.Diplopia was checked and the severity was recorded accordingly.Results The postoperative HAR％ was significantly improved compared with preoperative HAR％ in patients who underwent repair surgery (P ＜ 0.05).All patients with preoperative HAR％ ＞ 85％ had no postoperative diplopia.Five of 6 (83.33％) patients having a preoperative HAR％ ＜ 65％ had postoperative diplopia,including 3 patients of Grade Ⅲ diplopia.For the patients with HAR％ between 65％ and 85％,6 of 8 (75％) had postoperative diplopia,with one of them having Grade Ⅲ diplopia.Conclusions It is effective using the HAR％ to convert Hess graphic representation to a numerical value,and feasible to predict surgical outcomes of diplopia in patients undergoing surgery for orbital floor blowout fractures.