丙烯酸酯胶栓塞治疗眼眶静脉曲张的初步观察  

Preliminary observations of embolization treatment of orbital varices with Glubran 2 acrylic glue

作　　者：肖利华[1] 鲁小中[1] 王毅[1] 杨新吉[1] 魏红[1] 朱慧[1] 

机构地区：[1]武警总医院眼眶病研究所,北京100039

出　　处：《中华眼科杂志》2009年第5期436-440,共5页Chinese Journal of Ophthalmology

摘　　要：目的 探讨丙烯酸酯胶栓塞治疗眼眶静脉曲张的疗效。方法回顾性分析武警总医院眼眶病研究所2007年3至12月经临床确诊的眼眶静脉曲张患者28例（28只眼），其中男性11例，女性17例，年龄11至54岁，平均年龄32岁。均有明确的体位性眼球突出，右眶18例，左眶10例。在全身麻醉下行氰基丙烯酸酯胶栓塞术，手术入路为外侧开眶（9例），前路开眶（11例），结膜入路（7例）及直接经皮穿刺（1例）。开眶暴露畸形血管后，直视下用20G针分次在病变的不同位置穿刺并注入33％丙烯酸酯胶（其中7例在x线监视下）。6例患者行病灶部分切除。随访时间6至13个月，主要观察术前后视力、眼球运动、眼球突出度变化。结果28例患者症状体征缓解率为100％，其中完全缓解16例（57％），部分缓解12例（43％）。合并症主要包括视力丧失1例，眼球运动障碍3例，眼球突出2例（1～2mm）。无一例海绵窦合并症。结论经眼眶直接栓塞治疗静脉曲张方法简便，效果满意并同时矫正眼球内陷，是一种治疗静脉曲张的新方法。Objective To evaluate the outcome of embolization via orbital surgical exposure for a series of orbital varices. Methods This study is a retrospective review of 28 patients（28 eyes, 11 men, 17 women） which were diagnosed as orbital varix from March to December in 2007, in the Institute of Orbital Diseases. Patient＇s age ranged from 11 to 54 years old, mean 32 years old. Right orbit 18 cases, left orbit 10 cases. All patients is under general anesthesia, operative approach included lateral orbitotomy （9 cases）, anterior orbitotomy （11 cases）, transconjunctiva （7 cases） and percutaneous puncture （1 case）. During the operation, venous malformations were dilatated and punctured with an 20-gauge catheter needle, then injected into 33% Glubran 2 with several punctures with different orientations of the needle were required to reach the different lobules of the venous pouch. Results Proptosis, visual acuity and eye movement for pre- and post-treatment were observed. All the patients treated with 100% efficiency, in which 16 cases （57%）were complete resolution of the signs and symptoms, no proptosis with Valsalva and correct completely or partially enophthalmos, 12 cases （43%） marked resolution. Six patients partial resection as lesion was stiffen after glue injection, and can touch in anterior part of the orbit. Complications included the vision acuity loss （ 1 case）, limitation of ocular movement （ 3 cases）, and proptosis （ 2 cases）. Conclusion The embolization with Glubran 2 after direct surgical exposure is the safe and effective treatment for orbital varix and can correct some enophthalmos.

关 键 词：眼眶 静脉曲张 丙烯酸盐类 栓塞 治疗性 眼球内陷 

分 类 号：R686[医药卫生—骨科学]