目的 探讨经皮肤切口前路开眶摘除眼眶深部巨大海绵状血管瘤的手术效果及安全性.方法 回顾性病例研究.分析我院2015年1月至2021年6月经皮肤切口前路开眶摘除直径大于2 cm 眼眶深部海绵状血管瘤患者25例(25只眼)的临床资料.术后随访6个月,观察术中及术后并发症,比较术前术后最佳矫正视力(BCVA)及眼球突出度改善情况.结果 25例(25只眼)患者的肿瘤均顺利摘除.术中无大出血,术后除3只眼出现永久性瞳孔散大,均未出现严重并发症,无1眼复发.术后1、3、6个月BCVA分别为0.55±0.32、0.58±0.35、0.59±0.33,比术前0.37±0.16明显提高,差异均有统计学意义(均P<0.01);术后各时间点BCVA比较差异无统计学意义(P>0.05).术后1、3、6个月眼球突出度分别为(15.36±3.74)mm、(13.12±1.05)mm、(13.07±1.16)mm,比术前(19.75±2.22)mm明显变小,差异均有统计学意义(均P<0.01),术后3个月与术后1个月相比有所变小,差异有统计学意义;术后3个月与术后6个月相比差异无统计学意义(P>0.05).结论 采用经皮肤切口前路开眶无需切开眼眶骨壁就可以摘除眼眶深部巨大海绵状血管瘤,手术时间短,术后并发症少且安全性高.
Clinical effect of anterior orbital surgery trans-skin incision in the treatment of giant cavernous heman-gioma in deep orbit
Objective To investigate the efficacy and safety of anterior orbital surgery trans-skin incision in re-moving of giant cavernous hemangioma in the deep orbit.Methods A retrospective study was conducted on clinical data of 25 patients(25 eyes)who received anterior orbital trans-skin incision surgical removal of deep orbital cavernous hemangio-mas(diameter greater than 2 cm)from January 2015 to June 2021.All patients were followed up for 6 months.The intraop-erative and postoperative complications were observed,the best corrected visual acuity(BCVA)and the proptosis of preop-eration and postoperation were compared.Results All of the 25 patients with giant cavernous hemangiomas in the orbital muscle cone were completely and successfully removed.There was no major bleeding during the operation,no recurrence and no serious complications after the operation except 3 patients with permanent mydriasis.The BCVA at postoperative 1 month,3 months and 6 months were 0.55±0.32,0.58±0.35,0.59±0.33,which was significantly higher than that of 0.37±0.16 at preoperative(P<0.05).There was no statistical significance at each time point(P>0.05).The mean proptosis was 15.36±3.74 mm,13.12±1.05 mm,13.07±1.16 mm at postoperative 1 month,3 months and 6 months,which was signifi-cantly smaller than the mean preoperative proptosis 19.75±2.22 mm,and the difference was statistically significant(P<0.05).The mean postoperative proptosis at 1 month was smaller than that at 3 months(P<0.05),and there was no signifi-cant difference between postoperative 3 months and 6 months(P>0.05).Conclusions Anterior orbital surgery trans-skin incision can successfully remove the giant cavernous hemangioma in deep orbit without chiseling the orbital bone wall.It has the advantages of short operation time,fewer postoperative complications and high safety.
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