3例儿童眶内植物性异物的临床分析  

Intraorbital Vegetative Foreign Bodies in Children:3 Case Reports

作　　者：徐丽雯 熊伟伟[1] 彭小维[1] 谭意 XU Li-wen;XIONG Wei-Wei;PENG Xiao-wei;TAN Yi(Department of Ophthalmology,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院眼科,南昌330006

出　　处：《实用临床医学(江西)》2025年第1期66-68,共3页Practical Clinical Medicine

摘　　要：目的 总结儿童眶内植物性异物的临床特点和治疗要点。方法 收集3例儿童眶内植物性异物的临床资料,分析其临床诊疗经过,并对相关文献进行复习。结果 例1,男,2岁,摔伤后左眼红肿。CT检查显示眼眶植物性异物残留,手术后继续抗感染治疗,患眼红肿逐渐消退,眼球上转明显好转后出院。例2,女,6岁,摔跤后右眼被筷子插伤。CT检查显示右侧眼眶内上方异物,其后缘穿过眶上壁抵达右侧额叶脑实质;右侧额叶实质少许挫伤伴出血可能,诊断眶植物性异物合并颅脑挫伤。联合脑外科在全身麻醉下行右眼眶内异物取出术。术后生命体征平稳,积极抗感染治疗和密切观察,痊愈出院后定期随访。例3,男,5岁,摔跤后右眼被铅笔插伤。CT检查显示右眼眶异物(穿透筛窦至左眼眶尖),右眼球下方血肿,左眼异物端有压迫视神经可能。联合耳鼻喉科在全身麻醉下行眼眶异物取出术,术后视力恢复良好,出院后定期随访。结论 儿童眼眶植物性异物易误诊和漏诊,临床医师应详细询问病史,高度怀疑眶内植入性异物的患儿应完善相关检查以尽早明确诊断。及时手术,必要时联合脑外科、耳鼻喉科等共同处理,可取得较好的效果。Objective To summarize clinical features and therapeutic options of intraorbital vegetative foreign bodies in children.Methods Clinical data on 3 cases of intraorbital vegetative foreign bodies in children were collected,their clinical diagnosis and treatment were analyzed,and the relevant literature was reviewed.Results Case 1 involved a 2-year-old boy who presented with redness and swelling of the left eye after a fall injury.CT examination revealed residual orbital vegetative foreign bodies.After surgery,he continued anti-infective treatment,and the redness and swelling of the affected eye gradually subsided.The patient was discharged after significant improvement in the upward rotation of the eyeball.Case 2 involved a 6-year-old girl who sustained a chopstick injury to her right eye after a fall.CT examination revealed a foreign body in the upper part of the right orbit,with its posterior edge penetrating through the upper orbital wall and reaching the right frontal lobe brain parenchyma.There was also a possibility of minor contusion with hemorrhage in the right frontal lobe parenchyma,leading to a diagnosis of orbit vegetative foreign body combined with craniocerebral contusion.In collaboration with neurosurgery,the patient underwent right orbital foreign body removal under general anesthesia.Postoperatively,the patient’s vital signs were stable,and she recovered and was discharged after active anti-infective treatment and close observation,with regular follow-up scheduled.Case 3 was a 5-year-old boy who sustained a pencil injury to his right eye after a fall.CT examination revealed a foreign body in the right orbit(penetrating through the ethmoid sinus to the apex of the left orbit),a hematoma below the right eyeball,and possible compression of the optic nerve at the end of the foreign body in the left eye.In collaboration with otolaryngology,the patient underwent orbit foreign body removal under general anesthesia.Postoperatively,the patient’s visual acuity recovered well,and he was discharged with re

关 键 词：眼眶植物性异物 诊断 治疗 儿童 病例报告 

分 类 号：R779.7[医药卫生—眼科]