眼眶肿瘤个性化手术治疗临床观察

目的 观察眼眶肿瘤个性化手术治疗临床效果.方法 观察2011年1月至2015年12月收住院并手术眼眶肿瘤患者57例(57眼),术前根据影像学检查肿瘤不同位置分别采取前路开眶、外侧开眶、内外路联合开眶手术方式.前路开眶手术方法:眉弓下缘皮肤切口入路,下方穹窿结膜人手术路,内上方穹窿结膜和皮肤人路,外上方结膜入路,重睑皮肤人路,下睑缘下皮肤人路.对患者的视力及不良反应发生情况进行分析.结果 57例(57眼)患者术后的视力≤0.1、0.15～0.3比例均显著低于术前(P＜0.05),0.8～1.0、＞1.0比例均显著高于术前(P＜0.05);所有患者均顺利实施手术,术后所有患者伤口愈合良好,2例患者(2眼)术后出现眼球运动受限,1例眶深部肿瘤患者(1眼),3例泪腺部肿瘤患者(3眼)一过性上睑下垂,经相应治疗后均好转.结论 眼眶肿瘤个性化手术治疗临床效果显著.

Clinical observation of individualized surgical treatment for orbital tumors

Objective To observe the clinical effect of individualized surgical treatment for orbital tumors.Methods 57 hospitalized patients with orbital tumors (57 eyes) from January 2011 to December 2015 were observed,undergoing anterior orbitotomy,lateral orbitotomy,inside and outside united orbitotomy based on different positions of tumors showed by preoperative imaging examination.Anterior orbitotomy surgical method included eyebrow lower edge skin incision approach,lower fomix conjunctiva surgical approach,upper fomix conjunctiva and skin surgical approach,outside and upper trnsconjunctival approach,double eyelid skin approach,lower eyelid skin approach.The visual acuity and the incidence of adverse reactions were analyzed.Resul~ The ratio of postoperative visual acuity ≤0.1,0.15-0.3 in 57 patients (57 eyes) were significantly lower than those before operation (P＜0.05),the ratio of postoperative visual acuity 0.8-1.0,＞1.0 were significantly higher than those before operation (P＜0.05).All patients were successfully performed,the wound healed well in all patients,there were 2 cases of postoperative eyeball movement limited (2 eyes),1 case of deep orbital tumors (1 eye),3 cases of lacrimal gland tumor (3 eyes) with transient ptosis,improved after corresponding treatment.Conclusion Individualized surgical treatment for orbital tumors has clinical effect.