鼻内镜手术所致眼部并发症的处理

发布时间：2019-03-31 00:52

【摘要】：目的探讨鼻内镜手术所致眼部并发症的处理方法。方法鼻内镜手术所致眼部并发症32例,其中失明2例、复视伴视力下降5例、单纯复视不伴视力下降25例。CT未见眶腔内出血22例,行眶内壁骨折修复,直肌嵌夹松解术;眶腔出血10例,2例失明者行开眶减压、引流术、激素及神经营养剂治疗,3例单纯复视伴眶腔内出血和5例视力下降伴眶腔内出血者,保守治疗2周后行眶内壁骨折修复,直肌嵌夹松解术。结果 2例失明者中,1例术后4 d右眼光感(+),术后19 d~3个月视力0.3;另1例无效。30例眶内壁骨折修复,直肌嵌夹松解术后复视消失9例,17例有所缓解,4例无效;其中,8例保守治疗后手术者,5例有所缓解,3例无效。结论应积极、规范治疗鼻内镜手术所致眼部并发症,手术效果与眶壁骨折部位、直肌嵌夹损伤程度及手术时机有关。
[Abstract]:Objective to investigate the management of ocular complications caused by nasal endoscopic surgery. Methods 32 cases of ocular complications caused by nasal endoscopic surgery, including 2 cases of blindness, 5 cases of amblyopia with vision loss, 25 cases of simple diplopia without visual loss, 22 cases of no intraorbital hemorrhage on CT, were treated with repair of internal orbital wall fracture and relaxation of rectus muscle entrapment. Of the 10 cases of orbital hemorrhage, 2 cases were treated with orbital decompression, drainage, hormone and neurotrophic agents, 3 cases with simple diplopia with intraorbital hemorrhage and 5 cases with decreased vision with intraorbital hemorrhage. After 2 weeks of conservative treatment, orbital wall fractures were repaired. Relaxation of rectus muscle entrapment. Results among the 2 cases, the visual acuity of the right eye was 0.3 on the 19th day after (), on the 4th day after the operation, and the visual acuity was 0.3 at the 3rd month after the operation. In 30 cases of orbital internal wall fracture repair, 9 cases disappeared after operation, 17 cases were relieved, 4 cases were ineffective, among them, 8 cases underwent conservative treatment, 5 cases had remission and 3 cases had no effect, and the other 30 cases had no effect on orbital wall fracture, 9 cases had recuperation, 17 cases had remission and 4 cases had no effect after operation. Conclusion it is necessary to regulate the treatment of ocular complications caused by nasal endoscopic surgery. The operative effect is related to the site of orbital wall fracture, the degree of injury of rectus muscle entrapment and the timing of operation.
【作者单位】：中国医科大学附属第一医院;
【分类号】：R765.9;R779.6

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