眶尖综合征18例临床分析

发布时间：2018-06-26 01:40

本文选题：眶尖综合征 + 病因　；参考：《中国神经精神疾病杂志》2017年09期

【摘要】：目的探讨眶尖综合征的临床特征、病因和预后。方法回顾性总结18例眶尖综合征患者的临床资料,并结合文献进行分析。结果所有患者均出现视力减退、眼睑下垂、复视、前额头痛或眼痛等表现,但其首发症状可不同,视力下降或丧失8例,头痛、眼痛者7例,牙痛1例,鼻塞、流涕1例和眼球突出的1例。病因包括外伤6例(33%),占位5例(28%),非特异性炎症4例(22%)、感染3例(17%)。住院期间6例外伤性患者中视力、眼球活动障碍等症状有好转的5例,其中3例病情较轻者恢复更好,1例受伤较重的无好转;5例占位患者中1例蝶窦粘液囊肿患者手术后视力、眼球活动障碍等症状均有好转,其余4例诊断为眼眶腺样囊性癌或放疗后骨肉瘤患者无好转;4例非特异性炎症疾病患者治疗后2例视力、眼球活动障碍等症状较轻、病程较短的有好转,而另2例症状较重、病程较长的症状则无明显好转;3例感染性疾病者1例病程较短的症状有好转,而另2例病程较长或合并颅内感染患者无好转。结论眶尖综合征由多种病因引起,首发症状具有多样性,其预后与病因、是否及时就诊、早期诊断和早期治疗相关。
[Abstract]:Objective to investigate the clinical features, etiology and prognosis of orbital apex syndrome. Methods the clinical data of 18 patients with orbital apex syndrome were retrospectively analyzed. Results all the patients had visual acuity, blepharoptosis, diplopia, prefrontal headache or eye pain, but their initial symptoms were different: vision loss or loss in 8 cases, headache, eye pain in 7 cases, toothache in 1 case, nasal obstruction in 1 case. Snot in 1 case and exophthalmos in 1 case. The etiology included trauma in 6 cases (33%), space occupying in 5 cases (28%), nonspecific inflammation in 4 cases (22%) and infection in 3 cases (17%). The visual acuity and eyeball movement disorder were improved in 5 cases in 6 traumatic patients during hospitalization. Among them, 3 cases recovered better than those with mild condition, 1 case had no improvement and 1 case had postoperative vision in 1 case of sphenoid sinus mucocele, which was more serious than that of the mild case, and the visual acuity of 1 case of sphenoid sinus mucocele was better than that of the mild case. The other 4 cases were diagnosed as orbital adenoid cystic carcinoma or osteosarcoma after radiotherapy. The shorter course of disease was better, while the other 2 cases had more severe symptoms, while the longer course of disease had no obvious improvement. One case of the shorter course of disease had improved, while the other 2 cases had no improvement in the longer course of disease or the patients with intracranial infection. Conclusion Orbital apex syndrome is caused by many causes, the initial symptoms are diverse, its prognosis and etiology, timely visit, early diagnosis and early treatment are related.
【作者单位】：深圳市龙岗区第二人民医院内一科;中山大学附属第一医院神经科;
【基金】：广东省科技计划项目(编号:2014A020212487)
【分类号】：R777.5

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