眼眶囊性病变134例临床诊治分析  

Clinical analysis of 134 cases of cystic lesions of the orbit

作　　者：吴培培[1] 颜建华[1] 马文芳[1] 

机构地区：[1]中山大学中山眼科中心,眼科学国家重点实验室,广州510060

出　　处：《中国实用眼科杂志》2010年第12期1318-1321,共4页Chinese Journal of Practical Ophthalmology

基　　金：基金项目：广东省自然科学基金（编号036651）

摘　　要：目的 描述眼眶囊性病变病例的临床表现、诊断和治疗.方法 回顾性研究2001年1月至2009年3月期间诊治的眼眶囊性病变134例,分析其临床特征,影像学表现和手术治疗效果等.结果 134例眼眶囊性病变中,男性68例;女性66例,右眶63例;左眶71例;年龄6个月至84岁,平均42岁.最常见症状为肿块、眼球突出和复视等.超声波检查示肿物多呈边界清楚的无回声或低回声区,内部无明显血流信号.CT示囊肿内密度较均匀,CT值-198Hu～77.5Hu,增强扫描示囊壁增强,而囊内容物不被强化.MRI检查T1WI为低或等信号,T2WI呈高信号.全部病例经手术完整切除或部分切除等治疗.术后病理诊断眼眶皮样囊肿46例,表皮样囊肿58例,黏液囊肿11例,单纯性眼眶血肿12例,眼眶脓肿3例,寄生虫性囊肿2例,泪腺起源的单纯性上皮细胞囊肿及先天性囊性眼各1例.术后随访3月至8年,平均2.10年,治愈率98.50%,复发率1.50%.结论 眼眶囊性病变的诊断应综合病史和临床表现,影像学检查有助于准确的诊断,手术治疗效果好.Objective To describe the clinical findings, diagnosis and treatment of cystic lesions in volving the orbit. Methods Retrospective observational case series study. The medical records of 134 patients with cystic lesions involving the orbit who underwent treatment from January 2001 to March 2009 were reviewed and analyzed retrospectively. All patients were seen by Professor Yan Jian-hua at Zhongshan Ophthalmic Center of Sun Yet-sen University. The main contents were clinical features, imaging findings and therapeutic efficacy. Results Among 134 patients （134 eyes）, there were 66 females and 68 males from ages 3months to 84 years old （average 42 years）,with 63 lesions being the right orbit and 71 the left one. The most common symptoms were lumps, proptosis and diplopia. Ultrasonography showed that most lesions were presented as hypo-echoic or anechoic areas with distinct border and no blood flow signals inside. CT revealed that the lesions had homogeneous density. The CT value ranged from -198Hu to 77.5Hu. The cystic walls were enhanced while contents not. The MRI examination demonstrated isointensity or hypointensity in T1 WI and hyperintensity in T2WI. All the cases were operated and diagnosed by pathological examination. There were 46cases of orbital dermoid cysts, 58 epidermoid cysts, 11 mucoceles, 12 orbital hematoma, 3 orbital abscess, 2parasitc cyst, 1 lacrimal dacryops and 1 congenital cystic eye. They were followed up for 3 months to 8 years,2.1 years at average. The cure rate was 98.50% and the relapse rate was 1.50%. Conclusions Diagnosis of cystic lesions involving the orbit should combine with symptoms and signs. Imaging studies contribute to the diagnosis. Surgical treatment is effective.

关 键 词：眼眶 囊肿 诊断 治疗 

分 类 号：R739.7[医药卫生—肿瘤]