眼眶肿瘤切除术中眼部整形问题的研究

Study on Ocular Plastic Surgery in the Resection of Orbital Tumors

目的探讨不同手术方式对眼眶肿瘤后眼部的外观变化的影响,以期选择最适宜的手术入路方式。方法回顾性分析该院眼科自2010年1月—2015年1月间几种常见的眼眶肿瘤的开眶手术方式,分为前路开眶组71例(75只眼)和外侧开眶组70例(72只眼)。对经前路开眶和外侧开眶的病理患者适应症、优缺点及术后并发症及复发情况和眼眶肿瘤切除效果进行统计分析。结果前路开眶与外侧开眶术后患者肿瘤残留率比较,差异无统计学意义(P>0.05);术后前路开眶手术患者视力下降发生率低于外侧开眶手术患者(P<0.05);前路开眶患者术后上睑下垂、眼动障碍发生率低于外侧开眶手术患者(P<0.05);术后随访观察,前路开眶手术患者复发率为4.23%(3/71),外侧开眶手术患者复发率为14.29%(10/70),两组比较,差异有统计学意义(P<0.05)。结论前路开眶手术适应症不再局限于眶前部肿瘤的切除,提高了手术精细的程度,减少了术后对患者眼部外观的影响,具有重要的临床指导意义。

Objective To investigate the effect of different surgical methods on the changes of the ocular appearance of the orbital tumors in order to select the most appropriate surgical approach. Methods A retrospective analysis was done on the orbitotomy for several common orbital tumors in department of ophthalmology in this hospital from January 2010 and Jan-uary 2015. All the patients were divided into anterior orbitotomy group （71 patients, 75 eyes） and lateral orbitotomy group （70 patients 72 eyes）. The indications, advantages and disadvantages of the operation approaches, postoperative complica-tions, recurrence and orbital tumor resection efficacy of the two groups were recorded and analyzed. Results Anterior or-bitotomy was done in 71 patients （75 eyes）, lateral orbitotomy was done in 70 patients （72 eyes）, and anterior orbitotomy combined with lateral orbitotomy was done in 2 patients（3 eyes）. No statistically significant difference can be observed after treatment in tumor residual rate of the patients between anterior orbitotomy and lateral orbitotomy （P＆gt;0.05）;incidence of re-duced vision after operation was lower in patients receiving anterior orbitotomy than those undergoing lateral orbitotomy （P〈0.05）; postoperative follow-up showed that the recurrence rate was 4.23% in the anterior orbitotomy group and 14.29% in the lateral orbitotomy group, and there was significant difference between the two groups （P〈0.05）. Conclusion Anterior or-bitotomy indications are no longer limited to anterior orbital tumor resection. It makes the operation more subtle, and re-duces the negative impact on postoperative appearance of the patient＆#39;s eyes, which has great clinical significance.