189例眼眶内容剜除术临床分析  

Orbital exenterations： experience of 189 cases

作　　者：苏帆[1] 王毅[1] 杨新吉[1] 鲁小中[1] 黑砚[1] 肖利华[1] 

机构地区：[1]武警总医院眼眶病研究所,北京100039

出　　处：《中国实用眼科杂志》2014年第2期170-174,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的眼眶内容剜除术是一种破坏性手术，主要用于眼眶恶性肿瘤的治疗。文中收集了189例眶内容剜除术患者的临床资料进行分析。方法回顾性分析1999年11月至2010年8月在武警总医院眼眶病研究所进行眶内容物剜除术的189例患者资料。用Kaplan—Meier生存分析对眶内容剜除术后患者的生存率及不同病理类型患者的生存率进行评估。结果178例患者采用全眶内容剜除术，6例实施前部眶内容剜除术，5例实施后部眶内容剜除术。对189例眶内容剜除术患者的一般临床特征、临床症状、肿瘤原发部位及术后病理分型进行了分析。此外对13例术后出现并发症的原因进行了分析。结论研究表明最常见行眶内容剜除术的病理类型为腺样囊性癌、其次是恶性黑色素瘤、位于第三位的是视网膜母细胞瘤。对浸润性的非恶性肿瘤的分析表明，局部切除术后复发是导致最终行眶内容剜除术的重要原因，提示对良性肿瘤行初次局部切除手术治疗的重要性。尽管眶内容手术属于姑息性、极端性的手术方式，但并不意味着可以忽视对眶内容剜除术患者的复查随访，而出现术后并发症的患者经过积极的对症处理，也能得到有效地控制或完全的治愈。Objective Orbital exenteration is a destructive procedure reserved for the treatment of locally invasive malignancy or potentially life threatening orbital neoplasms. The authors report their experience and analyse of 189 cases of orbital exenteration performed over an ll year period, and this is a large- scale clinical research. Methods Records were reviewed retrospectively of all pa- tients who had undergone exenteration of the orbit from November 1999 to April 2010 inclusive, at Armed Police General Hospital. Kaplan-Meier analysis was used to estimate survival following exen- teration and pathologicaldiagnosis. Results 178 cases were undergone full orbital exenteration, and 11 cases with partial orbitalexenteration. Records of patient＇s clinical symptoms, original site and pa- thology results were reviewed and analyzed. In 13 cases, causes of post-operation complications had been analyzed. Conclusionln this study it was found that adenoid cystic carcinoma was the most common pathological diagnosis leading to exenteration, followed by malignant melanoma, and retinoblastoma. In the whole nonmalignant group, local recurrence following the original local resection was the key factor that lead- ing to the orbital exenteration, which remindedthe importance of the originat excision. Although the orbital exenter- ation was palliative and destructive, allcomplications had been well resolved pointing us that timely symptomatic treatments and regular follow-up should be well done.

关 键 词：眼眶内容剜除术 眶肿瘤 病理学 

分 类 号：R779.6[医药卫生—眼科]