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目的:探讨金属异物从皮肤、球结膜、巩膜进入筛窦内手术取出的技巧。方法:局部麻醉,先用镰状刀切开钩突,用开筛钳咬除钩突、筛泡,开放筛窦,看见异物位于筛窦内,用血管钳小心取出,异物约3×4㎜。结果:术前术后应用抗生素、止血剂等药物治疗,异物定位准确,手术顺利。术后6天视网膜、黄斑水肿消失,前房积血消失,视力恢复到4.8。结论:对于眼外伤疑有异物的病人,一定要进行X光、CT检查,确定异物的性质、大小、位置,方能顺利取出。
Objective: To explore the technique of metal foreign body removal from the skin, conjunctiva and sclera into the ethmoid sinus. Method: local anesthesia, the first use of sickle knife to cut open the uncinate process, with open scissors to bite in addition to uncinate process, sieve foam, open ethmoid sinus, foreign body is located in the ethmoid sinus, carefully remove with a vascular forceps, foreign body about 3 × 4㎜ . Results: Preoperative and postoperative antibiotics, hemostatic agents and other drugs, foreign body accurate positioning, the operation goes well. 6 days after the retina, macular edema disappeared, anterior chamber hemorrhage disappeared, visual acuity recovered to 4.8. Conclusion: For patients with foreign body suspected of eye injury, X-ray and CT examination must be performed to determine the nature, size and location of the foreign body before it can be successfully removed.