方法：前瞻性分析南昌大学附属眼科医院2020-04/2021-02接受眶下壁骨折整复术的眶下壁骨折患者43例43眼。患者随机分为两组，其中试验组20例20眼术中将浸润曲安奈德和鼠神经生长因子的明胶海绵放置于神经损伤处； 对照组23例23眼术中无特殊处理。术后随访6mo，通过定量感觉测试(两点定位觉、痛觉、触觉)比较患侧和健侧下睑区的测试结果，结果以不对称指数(AI)表示。

结果：基线结果显示，两组性别、年龄、受伤时间、术前两组间感觉测试无差异(均P>0.05)。两组患者术后1wk的两点定位觉、触觉、痛觉AI值均较术前升高(均P<0.05)，感觉障碍症状加重； 术后1mo不同程度改善，术后3mo痛觉有差异(P<0.05)； 术后6mo两点定位觉、触觉、痛觉均较治疗前明显改善(均P<0.01)。术后1mo，两组间两点定位觉、痛觉有差异(t=-2.082、-2.143，P=0.044、0.038)； 术后3mo，两组间痛觉有差异(t=-2.118，P=0.04)； 术后6mo，两组间定量感官测试无差异(P>0.05)。

结论：局部应用曲安奈德联合鼠神经生长因子治疗眶下壁骨折后的眶下神经损伤早期内恢复效果良好，优于术中无特殊处理组。

METHODS: Forty-three patients(43 eyes)with infraorbital wall fractures who underwent infraorbital wall fracture revision from April 2020 to February 2021 at the Affiliated Eye Hospital of Nanchang University were prospectively analyzed. Patients were randomly divided into two groups, in which 20 patients(20 eyes)in the experimental group had gelatin sponges infiltrated with triamcinolone acetonide and mouse nerve growth factor placed on the nerve injury intraoperatively; 23 patients(23 eyes)in the control group had no special treatment intraoperatively. At 6mo postoperative follow-up, the results of quantitative sensory testing(two-point localization, nociception, and touch)were compared between the affected and healthy lower lid areas, and the results were reported in an asymmetry index(AI).

RESULTS: Baseline results showed no significant differences between the two groups in terms of gender, age, time of injury, and preoperative sensory testing between the two groups(all P>0.05). The AI values of two-point localization sensation, tactile sensation, and pain sensation in both groups were higher at 1wk after surgery than before surgery(all P<0.05), and the symptoms of sensory impairment were aggravated, with different degrees of improvement at 1mo after surgery and statistically significant differences in pain sensation at 3mo after surgery(P<0.05), and two-point localization sensation, tactile sensation, and pain sensation were significantly improved at 6mo after surgery than before treatment(all P<0.01). At 1mo after surgery, the differences in two-point localization sensation and pain sensation in the test group were statistically significant compared with the control group(t=-2.082,-2.143; P=0.044, 0.038). At 3mo after surgery, there was a statistically significant difference in nociception in the test group compared to the control group(t=-2.118, P=0.04). At 6mo after surgery, there was no statistically significant difference in quantitative sensory testing between the two groups(P >0.05).

CONCLUSION: Local application of triamcinolone acetonide combined with mouse nerve growth factor for the treatment of infraorbital nerve injury after infraorbital wall fracture was effective in early internal recovery and superior to the group without special intraoperative treatment.