151例老年人眼眶内肿瘤临床分析  

Clinical study on 151 cases of orbital tumors in the elderly

作　　者：宋先 许孝义[1] 

机构地区：[1]山东大学齐鲁医院眼科,山东济南250012

出　　处：《山东大学学报（医学版）》2015年第3期93-96,共4页Journal of Shandong University:Health Sciences

摘　　要：目的分析老年人眼眶肿瘤的临床特点、病理学分类、手术方式及治疗效果。方法回顾性分析2004年1月至2014年3月收治的151例手术治疗的60岁以上老年人眼眶肿瘤患者。结果老年人眼眶肿瘤以眼球突出为主,可伴有眼斜、视力下降等。影像学检查可明确诊断肿瘤位置及大小,并决定手术方式。其治疗手术摘除包括前路开眶97例、外侧开眶39例、内外侧联合开眶10例、眶内容剜除5例。术后病理结果确定肿瘤性质,其中良性肿瘤103例(68.21%),前3位依次为海绵状血管瘤、泪腺多形性腺瘤、炎性假瘤及慢性炎症;恶性肿瘤48例(31.79%),前3位依次为恶性淋巴瘤、泪腺腺样囊性癌、泪腺多形性腺癌。结论老年人眼突应尽早行影像学检查排除眶内占位。治疗首选开眶手术,根据肿瘤位置、大小及患者可耐受程度选择手术方式。恶性淋巴瘤是60岁以上老年人最常见的眼眶恶性肿瘤。Objective To analyze the clinical characteristics,pathological classification,surgical approaches and therapeutic effect of orbital tumors in elderly patients. Methods Data of 151 cases of surgical treatment of orbital tumors in patients aged ≥ 60 years at Qilu Hospital during Jan. to Mar. 2014 were retrospectively reviewed. Results The clinical features included proptosis,restricted eye movements,impaired vision and so on. Imaging tests could help to identify the location and size of tumors,and select surgical methods. The surgical approaches included anterior orbitotomy in97 cases,lateral orbitotomy in 39 cases,medial orbitotomy in 10 cases,and exenteration in 5 cases. Of all tumors,103（ 68. 21%） were benign and 48（ 31. 79%） were malignant. Among the 103 benign cases,the top 3 were cavernous hemangioma,lacrimal gland pleomorphic adenomas,and idiopathic orbital inflammation. Among the 48 malignant cases,the top 3 were malignant lymphoma,adenoid cystic carcinoma and pleomorphic adenocarcinoma. Conclusion The elderly should take radiological examinations once proptosis appears. Orbital surgery is the preferred way of treatment,which should take into consideration the location and size of tumors and tolerance of patients. Malignant lymphoma is the most common malignant orbital tumor in the elderly.

关 键 词：眼眶肿瘤 老年 眼眶手术 病理学 

分 类 号：R739.72[医药卫生—肿瘤]