583例眼眶病致眼球突出的病因分析  

Etiological analysis of 583 cases of exophthalmos due to orbital disease

作　　者：杜军辉[1] 王雨生[1] 李夏[1] 

机构地区：[1]第四军医大学西京医院眼科、全军眼科研究所,西安710032

出　　处：《中华眼视光学与视觉科学杂志》2012年第7期425-428,共4页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的了解引起眼球突出的眼眶病的病因分类及分布状态。方法回顾性系列病例研究。分析第四军医大学西京医院1960—2008年收治的所有住院患者的病历资料，收集病历中记载有眼球突出的病例，排除其中资料不完整，诊断不明确的病例。共收集到583例患者的临床资料，对患者的性别、年龄、引起眼球突出的病因、临床表现、辅助检查进行分析。对资料进行分类计数，求百分比。结果引起眼球突出的病因可分为5类，即肿瘤（5813％）、甲状腺相关眼病（21．4％）、炎症性疾病（17．2％）、外伤（2．7％）和遗传及发育性疾病（0．3％）。根据来源可将肿瘤分为眶内起源肿瘤（72．9％）、副鼻窦肿瘤眶蔓延（18．5％）、造血系统肿瘤（4．1％）、颅脑肿瘤眶蔓延（3．2％）、眼内肿瘤眶蔓延（0．6％）和转移癌（0．6％）。引起眼球突出的常见病因依次为甲状腺相关眼病（21．4％）、海绵状血管瘤（11．2％）、炎性假瘤（10．3％）、良性脑膜瘤（6．5％）、静脉性血管瘤（6．0％）、眶蜂窝织炎（5.3％）、皮样及表皮样囊肿（4．6％）、神经鞘瘤（3．6％）、鳞癌（2．9％）和多形性腺瘤（2．7％）等。引起儿童眼球突出的病因依次为血管瘤、眶蜂窝织炎、皮样及表皮样囊肿、脑膜瘤、炎性假瘤、神经鞘瘤、神经胶质瘤、神经纤维瘤、甲状腺相关性眼病和横纹肌肉瘤等。结论眼球突出可由各种眼眶病引起，单侧眼球突出病因依次为肿瘤、甲状腺相关眼病、炎症等，双侧眼球突出病因以甲状腺相关眼病最多见，成人与儿童眼球突出常见病因不同，儿童以血管瘤多见，成人以甲状腺相关眼病多见。Objective To investigate the causes of exophthalmos due to orbital disease, including its classification and distribution. Methods It was a retrospective case series study. Data was collected on all cases of exophthalmos, excluding cases with incomplete data and unclear diagnoses. Medical records from 583 patients were retrospectively analyzed for gender, age, causes of exophthalmos, clinical manifestations, and laboratory examination. Number were counted and expressed with percentage. Results Causes that resulted in exophthalmos can be divided into 5 categories： tumor （58.3%）, thyroid-associated ophthalmopathy （21.4%）, inflammatory disease （17.2%）, trauma （2.7%）, and genetic and developmental disorders （0.3%）. Tumors can be further divided into those originating in intraorbital cavities （72.9%）, paranasal sinus tumors spreading into orbital cavities （18.5%）, hematopoietic tumors （4.1%）, brain tumors spreading into orbital cavities （3.2%）, intraocular tumors spreading into orbital cavities （0.6%） and metastatic carcinoma （0.6%）. Common causes of exophthalmos were thyroid-associated ophthalmopathy （21.4%）, cavernous hemangioma （11.2%）, inflammatory pseudotumor （10.3%）, benign meningiomas （6.5%）, venous angioma （6.0%）, orbital cellulitis （5.3%）, dermoid and epidermoid cysts （4.6%）, nerve sheath tumors （3.6%）, squamous cell carcinoma （2.9%）, pleomorphic adenoma （2.7%）, etc. The causes of exophthalmos in children included hemangioma, orbital cellulitis, dermoid and epidermoid cysts, meningioma, inflammatory pseudotumor, schwannoma, glioma, neurofibroma, thyroid eye disease, rhabdomyosarcoma, etc. Conclusion Exophthalmos can be caused by a variety of orbital diseases. The causes of unilateral exophthalmos are tumor, thyroid-associated ophthalmopathy, inflammation, etc. Bilateral exophthalmos is more commonly caused by thyroid eye disease. The causes of exophthalmos for adults and children are different, in which hemangioma is more co

关 键 词：突眼 眼眶病 肿瘤 眼眶 

分 类 号：R777.5[医药卫生—眼科]