【摘要】：目的探討鼻內(nèi)鏡手術(shù)所致眼部并發(fā)癥的處理方法。方法鼻內(nèi)鏡手術(shù)所致眼部并發(fā)癥32例,其中失明2例、復(fù)視伴視力下降5例、單純復(fù)視不伴視力下降25例。CT未見(jiàn)眶腔內(nèi)出血22例,行眶內(nèi)壁骨折修復(fù),直肌嵌夾松解術(shù);眶腔出血10例,2例失明者行開(kāi)眶減壓、引流術(shù)、激素及神經(jīng)營(yíng)養(yǎng)劑治療,3例單純復(fù)視伴眶腔內(nèi)出血和5例視力下降伴眶腔內(nèi)出血者,保守治療2周后行眶內(nèi)壁骨折修復(fù),直肌嵌夾松解術(shù)。結(jié)果 2例失明者中,1例術(shù)后4 d右眼光感(+),術(shù)后19 d~3個(gè)月視力0.3;另1例無(wú)效。30例眶內(nèi)壁骨折修復(fù),直肌嵌夾松解術(shù)后復(fù)視消失9例,17例有所緩解,4例無(wú)效;其中,8例保守治療后手術(shù)者,5例有所緩解,3例無(wú)效。結(jié)論應(yīng)積極、規(guī)范治療鼻內(nèi)鏡手術(shù)所致眼部并發(fā)癥,手術(shù)效果與眶壁骨折部位、直肌嵌夾損傷程度及手術(shù)時(shí)機(jī)有關(guān)。
[Abstract]:Objective to investigate the management of ocular complications caused by nasal endoscopic surgery. Methods 32 cases of ocular complications caused by nasal endoscopic surgery, including 2 cases of blindness, 5 cases of amblyopia with vision loss, 25 cases of simple diplopia without visual loss, 22 cases of no intraorbital hemorrhage on CT, were treated with repair of internal orbital wall fracture and relaxation of rectus muscle entrapment. Of the 10 cases of orbital hemorrhage, 2 cases were treated with orbital decompression, drainage, hormone and neurotrophic agents, 3 cases with simple diplopia with intraorbital hemorrhage and 5 cases with decreased vision with intraorbital hemorrhage. After 2 weeks of conservative treatment, orbital wall fractures were repaired. Relaxation of rectus muscle entrapment. Results among the 2 cases, the visual acuity of the right eye was 0.3 on the 19th day after (), on the 4th day after the operation, and the visual acuity was 0.3 at the 3rd month after the operation. In 30 cases of orbital internal wall fracture repair, 9 cases disappeared after operation, 17 cases were relieved, 4 cases were ineffective, among them, 8 cases underwent conservative treatment, 5 cases had remission and 3 cases had no effect, and the other 30 cases had no effect on orbital wall fracture, 9 cases had recuperation, 17 cases had remission and 4 cases had no effect after operation. Conclusion it is necessary to regulate the treatment of ocular complications caused by nasal endoscopic surgery. The operative effect is related to the site of orbital wall fracture, the degree of injury of rectus muscle entrapment and the timing of operation.
【作者單位】： 中國(guó)醫(yī)科大學(xué)附屬第一醫(yī)院;
【分類號(hào)】：R765.9;R779.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 李友忠;盧永德;龔興宏;郭運(yùn)凱;楊新明;;鼻內(nèi)鏡術(shù)致失明的預(yù)防和處理(附3例報(bào)告)[J];臨床耳鼻咽喉頭頸外科雜志;2009年08期

【共引文獻(xiàn)】

相關(guān)期刊論文 前5條

1 羅宇鴻;葉成剛;萬(wàn)玉瓊;;鼻竇內(nèi)鏡手術(shù)的眼部并發(fā)癥6例分析[J];臨床耳鼻咽喉頭頸外科雜志;2010年11期

2 張艾紅;;鼻竇炎鼻內(nèi)鏡手術(shù)病人圍手術(shù)期護(hù)理[J];內(nèi)蒙古中醫(yī)藥;2012年06期

3 徐前容;;老年病人鼻內(nèi)鏡圍手術(shù)期的護(hù)理[J];現(xiàn)代醫(yī)藥衛(wèi)生;2010年10期

4 苗培建;張正培;胡華偉;彭聲援;;鼻內(nèi)鏡篩竇開(kāi)放合并眶內(nèi)血腫致失明1例[J];中國(guó)眼耳鼻喉科雜志;2010年02期

5 林鳴國(guó);蘇亮;李幼珍;;鼻內(nèi)鏡鼻竇手術(shù)眼部并發(fā)癥9例[J];中國(guó)眼耳鼻喉科雜志;2011年06期

【二級(jí)參考文獻(xiàn)】

相關(guān)期刊論文 前3條

1 羅恒茂,裴春明;鼻內(nèi)鏡手術(shù)中控制性降壓麻醉后動(dòng)脈壓、心率與術(shù)野出血的關(guān)系[J];耳鼻咽喉頭頸外科;2003年06期

2 王杰,董釧,付啟紅,胥斌,楊德滿;鼻內(nèi)鏡手術(shù)并發(fā)癥與解剖因素關(guān)系探討[J];華西醫(yī)學(xué);2005年01期

3 裴嘉紅,安惠民,喬曉明,梁傳余;鼻內(nèi)鏡手術(shù)致右眼失明1例[J];西部醫(yī)學(xué);2005年03期

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