儿童眼眶嗜酸性肉芽肿的临床特点和治疗  

The clinical characteristics and treatment of obital eosinophilic granuloma in children

作　　者：赵尚峰[1] 张家亮[1] 史季桐[2] 傅继弟[1] 李永[1] 孙思[1] 吴江平[1] 康军[1] ZHAO Shang-feng ZHANG Jia-liang SHI Ji-tong FU Ji-di LI Yong SUN Si WU Jiang-ping KANG Jun(Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China)

机构地区：[1]首都医科大学附属北京同仁医院神经外科,100730 [2]首都医科大学附属北京同仁医院眼科,100730

出　　处：《眼科》2016年第5期314-317,共4页Ophthalmology in China

摘　　要：目的探讨儿童眼眶嗜酸性肉芽肿的临床表现、诊断和治疗。设计回顾性病例系列。研究对象2006年3月至2014年2月北京同仁医院神经外科收治的儿童眼眶嗜酸性肉芽肿27例。方法所有患者均行眼眶CT和MRI检查,并行手术治疗,部分辅助化疗,分析其临床特点和预后。主要指标儿童眼眶嗜酸性肉芽肿的流行病学、CT和MRI表现、病理特点和预后。结果16例儿童眼眶嗜酸性肉芽肿发生于眼眶外上壁,6例单纯发生于眶上壁,3例发生于眶外侧壁,2例同时累及眶外侧壁和颅底。病变均全部切除,术后症状均完全消失。3例有硬脑膜破坏,行硬脑膜切除和修补,4例有颞肌受侵犯。4例术后行化疗。平均随访2.36年,均未见病变复发和并发症。结论眼眶嗜酸性肉芽肿为良性病变,手术切除是单发病灶的最佳治疗方法,术后可辅助化疗预后好。Objective To investigate the clinical manifestation and treatment of orbital eosinophilic granuloma（EG） in children.Design Retrospective case series. Participants 27 patients with orbital EG admitted into Beijing Tongren Hospital from March 2006 to February 2014 were enrolled. Methods These patients were all preoperatively evaluated with computed tomography（CT） and Magnetic Resonance Image（MRI）. Surgical excision of the 1esions was performed and some cases were treated with chemotherapy postoperatively. The clinical charts and prognosis were analyzed. Main Outcome Measures Epidemiology, manifestation of CT and MRI, pathology characteristics and prognosis. Results The lesion involved the superior-lateral wall in 16 cases, orbital roof in 6 cases, lateral wall in 3 cases and both lateral wall and skull base in 2 cases. Total excision of the lesion was performed in all cases and the symptom disappeared. No complications occurred postoperatively. The dura and temporal muscle were found with infiltration of EG in 3 cases and 4 cases respectively. 4 cases received adjuvant chemotherapy after operation. No recurrence was noted during the follow-up examinations with a mean follow-up period of 2.36 years. Conclusions Orbital EG is a benign disease. Surgical resection is the most effective therapy. Adjuvant chemotherapy after surgery may be suggested. The overall prognosis for EG of the orbit is good. （Ophthalmol CHN, 2016, 25： 314-317）

关 键 词：嗜酸性肉芽肿 眼眶 儿童 

分 类 号：R779.6[医药卫生—眼科]