摘要
目的探讨眼眶瘘管形成的原因，提高其诊治水平。方法对1980年1月至2007年7月就诊于天津医科大学第二医院眼科的37例眼眶瘘管患者的病因、瘘管特点、影像学特征及治疗方法逐一进行回顾性分析。结果37例患者中因异物存留引发瘘管形成21例，包括植物性异物17例、医源性异物3例、花炮异物1例；眼眶囊肿9例，包括皮样囊肿5例、表皮样囊肿3例、额窦黏液囊肿1例；眼眶感染性炎症6例，包括骨髓炎5例、眼眶脓肿1例；嗜酸性肉芽肿1例。瘘管特点及影像学表现复杂，但具有一定规律性。治疗以手术清除病灶，切除瘘管为主，同时治疗毗邻结构病变，消灭复发根源。结论眼眶瘘管形成的常见病因是异物存留、皮样囊肿和骨髓炎，其发病机制包括感染性炎症、先天性发育异常、手术及肿瘤。B型超声、CT、MRI检查对病灶的定位及定性诊断具有重要价值。正确判断病因，分析瘘管特点，是制定正确的治疗方案、根除瘘管的关键。
Objective To present some instruction in diagnosis and treatment of the orbital fistula by analyze the clinical manifestation. Method The clinical data for 37 cases with orbital fistula treated during 1980 to 2007 were analyzed retrospectively. Results Among 37 cases with orbital fistula, there are 21 cases caused by foreign bodies, including 17 cases by retained wooden bodies, 3 eases by iatrogenic foreign bodies and 1 case by firecrackers. There are 9 cases caused by orbital cysts, including 5 cases dermoid cysts, 3 cases epidermoid cysts and 1 ease frontal mucopyocele. There are 6 cases orbital infection inflammation, including 5 cases osteomyelitis and 1 case orbital abscess. There is 1 case eosinophilic granuloma. Different etiologies have characteristic features. Medical history, fistula examinations and imaging examinations must be analyzed synthetically in order to make proper etiological diagnosis. Eradicate etiologies and resect fistula are most important. It is necessary to make an ancillary therapy, such as ENT treatment. Conclusions The common etiologies of orbital fistula are retained foreign body, dermoid cysts and osteomyelitis. The pathogenesy include infective inflammation, congenital heteroplasia, operation and tumor. B-scan ultrasonography, CT, and MRI can be used for the localization and qualitation diagnosis. There are comprehensive approaches for diagnosis and management of this type of injury. In order to give an effective therapy, we must make an accurate diagnosis and analyze the features of fistula.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2009年第25期1774-1778,共5页
National Medical Journal of China
关键词
眼眶
瘘管
病因
诊断
治疗
Orbit
Fistula
Etiology
Diagnosis
Therapeutic
