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| 篇名 |
显微神经外科手术治疗眼眶内肿瘤 |
| 作者 |
舒凯1牛洪泉 雷霆 |
| 中英文摘要 |
摘要 目的 了解眼眶肿瘤的临床特点，探讨其手术入路及治疗。 方法 对1997年至2003年我院收治的31例眼眶肿瘤手术病例进行了回顾性分析，对其临床表现、病理及手术入路进行分析。其中男20例，女11例；年龄从15~59岁，平均38岁；病程从1个月~10年；所有病例通过影像学和眼科检查，随访1~5年。 结果 常见的眼眶内肿瘤依次为脑膜瘤、炎性假瘤、神经纤维瘤和血管瘤。肿瘤全切27例，次全切除2例。无手术死亡及严重并发症，80%的病例手术后视力改善。 结论 手术前应通过影像学检查对病变的性质、与视神经的关系和扩展方向作出精确的判断。现代神经外科的显微技术使得采用经颅处理眶内病变的安全性大为提高。
Abstract Objective To sum up the clinical characteristics of orbital tumors and to discuss the neurosurgical approaches and the treatment of orbital tumors. Methods From 1997 to 2003, 31 patients including 20 males and 11 females with orbital spaceoccupying lesions had been surgically treated in Tongji Hospital. Their age ranged from 15 to 59 years with an average of 38 years. They were symptomatic for 1 months to 10 years. All patients were followed-up from 1 to 5 years by imaging studies and ophthalmological investigation. Results The most common diagnosis was meningioma, and other were inflammatory pseudotumor, fibroma and hemangioma . Among them, total removal was achieved in 27 patients, subtotal removal in 2 patients and no patient died. There was no serious postoperative complication. Eighty percent of the patients improved on visual acuity. Conclusion Orientation and spatial localization of the lesion should be achieved preoperatively by means of imaging methods. Although orbital tumor is a pathological entity situated at the confluence of different specialties, the neurosurgical approach should be considered as the most appropriate one without major risk of visual loss. Modern techniques with microscope have greatly improved these results.
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