新疆地区63例眼眶肿瘤的临床分析

Clinical analysis for the treatment of 63 cases of orbital tumors in Xinjiang

目的探讨新疆维吾尔自治区眼眶肿瘤的临床特点、组织病理学分类、治疗方式及预后。方法回顾性系列病例研究。对解放军474医院在2005年8月至2009年8月收治包括各民族的63例（64只眼）眼眶肿瘤病例进行了回顾性分析。结果本组病例中以良性肿瘤为主，民族分布为：汉族37例，维族16例（16只眼），回族4例，蒙古族3例，哈萨克族3例。血管性肿瘤占大多数，其次为囊肿、炎性假瘤、神经源性肿瘤、泪腺混合瘤、脂肪瘤、包虫。恶性肿瘤以横纹肌肉瘤和泪腺腺癌为主，其次为非霍奇金淋巴瘤。手术方式以眶部皮肤入路或前部开眶为主，其次为经外眦切开联合下穹隆结膜入路、经外侧壁开眶。手术后较严重的并发症为视力下降，2例炎性假瘤患者出现复发。结论新疆维吾尔自治区眼眶肿瘤类型及发病情况与其他地区眼眶肿瘤发病情况基本一致；眼眶包虫具有地域特异性；手术摘除是主要而有效的治疗方式，预后与肿瘤累及范围、术前的准备、术中操作、术后处理以及临床经验技巧有关。

Objective To analyse the clinical features, histopathological classifications, treatments and prognosis of orbital tumors in Xinjiang. Methods The authors retrospectively analyse 63 patients （64 eyes） with orbital tumors, including all nationalities which had been received and treated in ophthalmic department of the PLA 474th Hospital during 2005 to 2009. Results The nationality composition in our cases was 37 Han, 16 Uygur （ 16 eyes）, 4 Hui, 3 Mongol, and 3 Kazak. Our data mainly consisted of benign tumor., in which, the majority were the vascular tumors, and then were cysts, inflammatory pseudotumor, neurogenic tumors, mixed tumors of lacrimal gland, lipoma and hydatid. The malignant tumors mainly consisted of rhabdomyosarcoma and adenocarcinoma of lacrimal gland, then was non-Hodgkin lymphoma. The operation methods we selected were approaching by orbital skin or anterior skin incision, ateralorbitotomy and approaching by outer canthus incision plus lower fornical conjunctiva incision. The severe postoperative complication was impaired vision, and 2 patients with inflammatory pseudotumor had recrudesced. Conclusions There is no difference on the types and morbidity situation of orbital tumors between Xinjiang and other areas in general,in addition orbital hydatid which was closely related to regional characteristic of Xinjiang, Surgical excision is the main and effective treatment, the prognosis is related to the local tissue extension of tumor, comprehensive pre-operation preparations, careful operation, appropriate post-operative managements and rich clinic experience of doctor.