Objective To provide references for clinical management of patients with orbital blow-out fractures. Methods Evidence was retrieved from The Cochrane Library online (Issue 1, 2009), ACP online, NGC (1998 to March 2009), PubMed (January 1950 to February 2009), and CBM (1994 to February 2009). The collected evidence was then graded. Results After preliminary research, we identified 12 relevant articles: either retrospective studies or comments from specialists. They studied orbital soft tissue entrapment, diplopia, enophthalmos, or severe oculocardiac reflex in the surgical indications of orbital blow-out fractures. Most of the literature suggested less than five days after the injury incursion for children and less than two weeks for adults was the optimal time to undergo operation. However, advanced surgery was still a good option for the patients that could not undergo early surgery. With regard to the use of poly-pdioxanon- foil and titanium-dynamic mesh, two randomized controlled trials suggested that the former was superior to the latter. Conclusion The application of this surgery should be cautious because of low levels of evidence. Individual therapies should be used after close consideration of clinical characteristics.
目的:探讨腹腔镜胆囊切除术的适应症及适用人群。方法:回顾分析我院1998～2007年2168例腹腔镜胆囊切除术的疾病种类及年龄、性别分布。结果:胆结石伴慢性胆囊炎1994例占91.97%,胆囊息肉106例,占4.89%,急性胆囊炎伴胆囊结石68例,占3.14%;男性575例,占26.52%,女性1693例,占73.48%;年龄lt;20岁21例,占0.97%,21~55岁1570例,占72.70%,56~65岁363例,占16.74%,年龄gt;66岁208例,占9.59%,最小年龄15岁,最大年龄84岁。手术中转59例,占2.72%。结论:慢性胆囊炎、胆囊结石、胆囊良性隆起样病变是腹腔镜胆囊切除术的主要适应症;腹腔镜胆囊切除术适用于各年龄段的患者。