78例眼眶肿瘤手术治疗的临床分析

发布时间：2018-05-18 11:27

本文选题：眼眶肿瘤 + 手术入路的选择　；参考：《吉林大学》2011年硕士论文

【摘要】：目的:探讨不同手术方式治疗眼眶肿瘤的临床疗效。方法:收集我院眼科2005年1月至2010年12月行手术治疗的眼眶肿瘤患者78例(78只眼)进行系统回顾分析。78例中良性肿瘤65例:海绵状血管瘤21例,炎性假瘤5例,神经纤维瘤10例,神经鞘瘤9例,皮样囊肿7例,泪腺混合瘤6例,脂肪瘤5例,粘液囊肿1例,脑膜瘤1例。恶性肿瘤13例,淋巴瘤8例,多形性腺癌4例,视网膜母细胞瘤球外蔓延1例。本组病例中男性45例,女性33例,年龄最大77岁,最小11个月,平均年龄38岁。发病时间最长30年,最短5天。根据肿瘤的部位、性质不同采取手术方法不同。其中(1)前入路开眶45例(2)眶外侧壁切开28例(3)内外联合开眶术3例(4)眶内容物剜除2例。术后随访3至36个月,观察术后并发症及复发情况。结果:(1)78例患者中,肿瘤全部切除73例,部分切除5例。(2)复发病例8例,泪腺混合瘤2例,神经纤维瘤2例,粘液样囊肿1例,淋巴瘤1例,炎性假瘤1例,脑膜瘤1例。复发率为10.25%,(3)术后出现眼球运动障碍8例,视力下降9例,其中2例视力丧失,眶内出血10例,上睑下垂6例,瞳孔改变6例。结论:1.手术切除是治疗眼眶肿瘤的有效方法。2.前入路开眶术适用于大部分血管瘤及位置靠前的部分良性肿瘤。3.外侧开眶术适用于球后、肌圆锥内的肿瘤。4.眼眶肿瘤摘除术常见的并发症为眶内出血、视力下降、眼球运动障碍。
[Abstract]:Objective: to investigate the clinical effect of different surgical methods on orbital tumors. Methods: from January 2005 to December 2010, 78 patients (78 eyes) with orbital tumor treated surgically in our hospital were analyzed retrospectively. Among them, 65 cases were benign tumor, 21 cases were cavernous hemangioma, 5 cases were inflammatory pseudotumor, 21 cases were cavernous hemangioma, 5 cases were inflammatory pseudotumor. There were 10 cases of neurofibroma, 9 cases of neurilemmoma, 7 cases of dermoid cyst, 6 cases of mixed lacrimal gland tumor, 5 cases of lipoma, 1 case of mucocele and 1 case of meningioma. 13 cases of malignant tumor, 8 cases of lymphoma, 4 cases of pleomorphic adenocarcinoma and 1 case of extrabulbar retinoblastoma spread. There were 45 males and 33 females, aged 77 years and 11 months, with an average age of 38 years. The longest onset time was 30 years and the shortest was 5 days. According to the location of the tumor, the nature of the operation is different. Of them, 1) anterior approach was used to open the orbit in 45 cases (2 cases) lateral wall incision was performed in 28 cases (3 cases) and combined internal and external orbital surgery in 3 cases (4 cases). 2 cases were enucleated from the contents of the orbit. All patients were followed up for 3 to 36 months to observe postoperative complications and recurrence. Results among 78 cases, 73 cases were completely resected, 5 cases were partially resected), 8 cases were recurrence, 2 cases were mixed tumor of lacrimal gland, 2 cases were neurofibroma, 1 case was mucoid cyst, 1 case was lymphoma, 1 case was inflammatory pseudotumor and 1 case was meningioma. The recurrence rate was 10.25%) 8 cases had ocular movement disorder, 9 cases had visual acuity loss, 2 cases had loss of vision, 10 cases had intraorbital hemorrhage, 6 cases had ptosis and 6 cases had pupil changes. Conclusion 1. Surgical resection is an effective method for the treatment of orbital tumors. Anterior orbital approach is suitable for most hemangiomas and partial benign tumors located at the anterior. 3. Lateral orbital surgery is suitable for retrobulbar, intramuscular conical tumors. 4. The common complications of orbital tumor excision are intraorbital hemorrhage, visual acuity loss and ocular movement disorder.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R739.72

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