眼眶病误诊原因分析

Analysis of misdiagnosis and missed diagnosis of orbital diseases： 8 cases report

目的分析4例眼眶病的误诊和漏诊原因，为眼眶病的正确诊断和治疗提供帮助。方法对近半年误诊或漏诊的4例住院病人的初诊和最后诊断的不同结果进行分析。结果4例患者中，1例颈动脉海绵窦瘘分别误诊为外展神经麻痹和眶尖部炎性假瘤；1例眶尖部炎性假瘤早期诊断为眶上神经痛；1例泪囊癌按泪道阻塞门诊长期治疗；1例眶蜂窝织炎治愈后复查CT发现有黏液囊肿。结论眼眶病涉及范围错综复杂，详细地询问病史和检查，阳性体征的仔细分析，影像学的合理利用，将会大大提高眼眶病诊断的正确率。

Objective To analysis the cause of misdiagnosed or missed diagnosis of orbital disease, which may facilitate to reach the correct diagnosis. Methods Eight sequence cases which were misdiagnosed or missed diagnosed in initial diagnosis in recent half year were collected. The initial and final diagnosis was analyzed. Results In 4 cases, 1 cases of CCF was misdiagnosed as abducens paralysis or orbital pseudotumor, 1 case of orbital apex pseudotumor was misdiagnosed as supraorbital neuralgia, 1 case of lacrimal sac carcinoma was misdiagnosed as obstruction of lacrimal duct, The maxillary sinus mucocele was revealed after orbital cellulitis cured and revised by CT. Conclusions Orbital diseases are complex in its locations, inquiried on the detailed case history and complete inspection thoroughly, analyzing the positive signs carefully, combined with imaging examination properly, can we improve the rate of correct diagnosis in the orbital diseases.