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目的临床分析60例眼眶疾病的手术疗法并总结经验。方法对60例(60眼)眼眶病患者(其中眼眶肿瘤49例,爆裂性骨折5例,眼眶内异物6例)根据病因及病变位置选择不同的手术入路,进行手术治疗,术后半年观察视力及外观变化。结果肿瘤完整取出者45例,肿瘤囊内取出、囊袋完整摘除或肿瘤部分摘除者3例,肿瘤未取出者1例。异物完整取出者6例。5例骨折患者medper在位,眼球凹陷完全矫正者4例,残留2mm者1例。术后视力无变化者59例,术后视力丧失者1例;上睑下垂者1例。结论术前应行必要的影像学检查并详细分析检查结果,选择最佳手术入路。充分估计手术的风险和可能出现的并发症,制定周密的手术方案,与患者进行有效的沟通。尽量在直视下进行手术操作,控制术中的出血。密切监测瞳孔的状态。术后做好引流措施及常规进行视力监测。
Objective To analyze the surgical treatment of 60 cases of orbital diseases and summarize the experience. Methods 60 cases (60 eyes) of orbital patients (including 49 cases of orbital tumor, burst fracture in 5 cases, orbital foreign body in 6 cases) according to the etiology and location of the lesion selected by different surgical approach, surgical treatment, six months after surgery Visual acuity and appearance changes. Results 45 cases of complete tumor removal, removal of the tumor capsule, complete removal of the capsule or tumor part of the removal of 3 cases, the tumor was not removed in 1 case. Complete removal of foreign body in 6 cases. In 5 cases, the medper was in the position of fracture, 4 cases were completely corrected in the concave eyeball, and 1 case was left with 2mm residual. No change in visual acuity in 59 cases, 1 case of postoperative loss of vision; ptosis in 1 case. Conclusion The necessary preoperative imaging examination and detailed analysis of the test results, select the best surgical approach. Fully estimate the risk of surgery and possible complications, well-developed surgical programs, and effective communication with patients. As far as possible under direct vision for surgical procedures to control intraoperative bleeding. Closely monitor pupil status. Postoperative drainage measures and routine visual acuity monitoring.