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目的进一步探讨泪囊区肿物的临床特点、手术方法及并发症的预防。方法对2004年1月—2014年12月在河南省眼科研究所手术治疗的泪囊区占位性病变95例患者的临床表现、影像学特征和治疗进行回顾性分析。结果术后病理结果:泪囊脓肿42例(44.21%),泪囊囊肿15例(15.79%),内翻性乳头状瘤9例(9.47%,2例为复发后恶性变),炎性假瘤12例(12.63%),慢性炎症合并肉芽组织增生6例(6.32%),非霍奇金淋巴瘤3例(3.16%),鳞状细胞癌3例(3.16%),黑色素瘤2例(2.11%),腺癌1例(1.05%),基底细胞癌例(1.05%),隆突性纤维肉瘤1例(1.05%)。结论泪囊区占位性病变根据病史、临床表现及影像学(MRI、CT及彩色超声多普勒)检查,进行准确的定性诊断,来选择适宜的手术方式(包括肿物切除术、全泪道成形术及硅胶管植入术),从而顺利并完整切除肿物;对于恶性肿瘤,术后必要时辅以放、化疗,预后良好。
Objective To further explore the clinical characteristics of lacrimal sac tumor, surgical methods and complications prevention. Methods The clinical manifestations, imaging features and treatment of 95 patients with dacryocyst area occupying lesions underwent surgical treatment in Henan Eye Institute from January 2004 to December 2014 were analyzed retrospectively. Results Postoperative pathologic findings included 42 cases (44.21%) of lacrimal sac abscess, 15 cases (15.79%) of lacrimal sac, 9 cases of inverted papilloma (9.47%, 2 cases of malignant relapse), inflammatory pseudo- (12.63%), 6 cases (6.32%) of chronic inflammation with granulation tissue hyperplasia, 3 cases of non-Hodgkin’s lymphoma (3.16%), 3 cases of squamous cell carcinoma (3.16%) and 2 cases of melanoma 2.11%), adenocarcinoma in 1 case (1.05%), basal cell carcinoma (1.05%) and protuberance fibrosarcoma in 1 case (1.05%). Conclusions Dysplastic lesions in the dacryocyst region were diagnosed according to their medical history, clinical manifestations and imaging (MRI, CT and color Doppler ultrasound), and the accurate qualitative diagnosis was performed to select the suitable surgical methods (including tumor resection, And angioplasty and silicone tube implantation) to smooth and complete removal of the tumor; for malignant tumors, supplemented with radiotherapy and chemotherapy when necessary, the prognosis is good.