眼眶异物的临床特点和手术治疗  

Clinical characteristics and surgical treatment in patients with intraorbital foreign bodies

作　　者：邬永娟[1,2] 文芸[1] 颜建华[1] 

机构地区：[1]广东省高州市人民医院眼科 [2]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：《中华眼视光学与视觉科学杂志》2017年第3期186-189,共4页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的 总结眼眶异物的临床特点和手术治疗方法.方法 回顾性系列病例研究.分析中山大学中山眼科中心2002年1月至2013年7月期间诊治的22例眼眶异物患者的资料,对其临床表现、影像学资料和手术治疗方法进行统计.结果 22例患者中,男19例,女3例;年龄3-67岁,≤14岁者占46%;右眼眶10例,左眼眶12例.植物性异物占73%,异物位置以眼眶上部最多,占41%;其次分别为内侧（27%）、外侧（18%）、下部（9%）和锥后段（4%）.术前视力损害占50%,眼球运动受限、斜视和上睑下垂占46%.眼眶CT和MRI显示植物性异物均有条状、棒状等高密度异物影或低信号异物影.全部病例均完整取出异物,其中前路开眶21例,侧壁开眶1例;21例行1次手术,1例行2次手术;所有患者术后随访期内均没有出现新增视力下降和眼球运动受限,仅2例有暂时性轻度上睑下垂.结论眼眶异物以男性儿童多见,影像检查有利于准确诊断,前路开眶手术效果好.Objective To summarize the clinical features of intraorbital foreign bodies and the surgical management. Methods Retrospective study of 22 clinical cases. Clinical manifestations, image findings, and surgical treatment of patients with intraorbital foreign bodies diognosed and treated in the Zhongshan Ophthalmic Center between January 2002 and July 2013 were reviewed. Results Of the patients, 19 were males and 3 were females with ages from 3 to 67 years. Patients with ≤14 years of age accounted for 46% of the cases. The right orbit was affected in 10 cases and the left one in 12 cases. Of the cases, 73% had an organic intraorbital foreign body. The sites of the foreign bodies within the orbit were superior （41%）, medial （27%）, lateral （18%）, inferior （9%）, and muscle cone posterior segment （4%）. Half of the subjects presented with preoperative visual impairment, and 46% with preoperative limited motility/strabismus and ptosis. Orbital computed tomography scans showed that the organic foreign bodies appeared as rod-like strips with high density compared to the surrounding soft tissue. Magnetic resonance imaging revealed hypointense images on both T1WI and T2WI. The intraorbital foreign bodies were completely removed by anterior orbitotomy in 21 cases and by lateral orbitotomy in one case. Among them, 21 cases underwent a single operation and one case had two operations. Only two patients had temporary mild postoperative ptosis. Conclusion Intraorbital foreign bodies usually occurred in male children. Orbital imaging played an important role in accurate presurgical diagnoses. Anterior orbitotomy usually resulted in a satisfactory surgical outcome.

关 键 词：眼眶 眼异物 穿透性眼损伤 眼外科手术 前路开眶 

分 类 号：R779.14[医药卫生—眼科]