眼眶肿瘤摘除手术致意外视力丧失的临床分析  

Clinical analysis of 22 cases of accidental vision loss in orbital tumor removal surgeries.

作　　者：周晓冬[1] 宋国祥[1] 

机构地区：[1]天津医科大学第二医院天津市眼眶病研究所,天津300211

出　　处：《眼外伤职业眼病杂志》2007年第4期266-270,共5页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的分析眼眶肿瘤摘除手术致意外视力丧失的主要原因。方法对1989年1月至2001年12月我院施行的眼眶肿瘤摘除手术发生的术眼意外视力丧失病例进行回顾性分析。结果1923例(1923眼)眼眶肿瘤摘除手术,22例发生意外视力丧失,占全部病例的1.14%。术眼视力丧失于术中或术后2天内发生,其中18例于手术当天发生。全部肿瘤均位于眼眶的中后部,其中15例达到眶尖,4例为一眶多瘤。诊断方法包括眼底检查、超声检查、视觉电生理检查、荧光素眼底血管造影等。视力丧失的原因有视网膜中央动脉栓塞(8例)、视神经损伤(8例)、急性高眶压(3例)、血肿压迫视神经(1例)及原因不明(2例)。结论眼眶肿瘤摘除致意外视力丧失原因很多,详尽的术前检查、正确的手术操作及术后处理、及时有效的抢救措施有助于避免视力丧失的发生。一眶多瘤、眶尖部肿瘤、与视神经粘连肿瘤等是发生视力丧失的高危因素。Objective Analysing the main causes and regardnes＇s of vision loss in orbital tumor removal operation for the sake of accidental vision loss and becapable of efficient salvage. Methods 22 cases of accidental vision loss happened in tumor removal surgeries within 13 years were reviewed as a retrospective study. Results Of 1923 surgeries, 22 accidental vison loss happened. 80 percent happened within 2 days after surgery. All of the tumors located at middle - posterior orbit, 15 tumors were at the orbit apex and 4 cases were more than one tumors. Fudus examination, ultrasonography,VEP,ERG and FFA were used in the diagnosis. Conclusions A particular examination before surgery, preciseness in and after operation and effective management in good time may help preventing vision loss.

关 键 词：眼眶肿瘤 手术 视力丧失 

分 类 号：R739.7[医药卫生—肿瘤]