B型超声在诊治眼眶血肿中的应用价值

The value of B-mode ultrasound in the diagnosis and therapy of orbital hematoma

目的 总结眼眶血肿的超声学表现以及B型超声引导下穿吸治疗的体会.方法 选取天津医科大学第二医院眼科1989年12月至2008年1月间收治的19例经B型超声引导下局部穿刺抽吸证实的眼眶血肿患者资料,进行分析归纳与总结.结果 19例患者声像图均显示为边界清楚的异常回声占位病变.B型超声检查结果：位于眶顶骨膜下间隙9例,中央间隙8例,周围间隙2例.占位病变呈扁平状8例,不规则形4例,类圆形2例,圆锥形3例,葫芦状1例,僧帽状1例.内回声强度：低回声10例,无回声6例,中等回声1例,1例为中、低回声,并有落雪样回声,1例表现为低回声区中后部有-厚薄不-的中等同声区.19例均具有可压缩性.所有患者均在B型超声引导下,经皮进行局部穿刺抽吸,18例抽出陈旧性血性液体,1例未抽出.4例穿吸物细胞学检查为红细胞.结论 B型超声检查可揭示眼眶血肿的动态演变过程,在B型超声引导下,把握穿刺时机,进行局部穿刺抽吸,是眼眶血肿安全、有效的治疗手段.

Objective To summarize the ultrasonic appearances of orbital hematoma, and the receptions of needle aspiration with ultrasonic guidance. Methods The study data consisted of 19 patients with orbital hematoma, which had been verified by needle aspiration in ophthalmic department of the No.2 Hospital of Tianjin Medical University during Dec, 1989 to Jan, 2008. Results The consequence of B-mode ultrasound inspection： 9 were located in subperiosteal space, 8 in central space, and 2 in peripheral space. The shape of 19 masses included applanation （8）, irregularity （4）, round （2）, conus （3）, cucurbit （1）, headcap （1）. Ten had low echo, 6 no echo, 1 medium echo, 1 snowy low and medium echo, and 1 low echo with inhomogeneous medium echo area. All of the cases had compressibility. All of the patients had needle aspiration under the ultrasonic guidance. Eighteen cases obtained hemal fluid, 1 case not. Cytological examination of 4 cases was akaryocyte.Conclusions B-mode ultrasound inspection can disclose the dynamic developing procedure of orbital hematoma. Using the guidance of ultrasound, needle aspiration is a safe and effective therapeutic tool at optimal opportunity.