鼻-鼻窦炎眶并发症28例临床分析

Clinical analysis of orbital complications due to rhinosinusitis in 28 cases

目的 分析鼻-鼻窦炎眶并发症的临床特点,为该病的诊断和治疗提供参考.方法 回顾性分析2009年8月至2017年4月青岛大学附属医院耳鼻咽喉头颈外科收治的28例鼻-鼻窦炎眶并发症患者的临床资料.28例患者中并发眶周蜂窝织炎1例,眶内蜂窝织炎9例,眶骨膜下脓肿13例,眶内脓肿5例;其中年龄小于14岁者19例,14-17岁者2例,18岁及以上者7例;单纯药物治疗8例,药物联合手术治疗20例.分析28例患者的临床特点及预后.结果 所有患者随访2-19个月,全身症状及眼部症状均消失,鼻腔通气功能恢复良好.结论 鼻-鼻窦炎眶并发症的治疗包括单纯药物治疗和药物联合手术治疗,治疗方案的选择取决于患者病情的分期.及时的诊断、合理的治疗有利于患者的康复.

Objective To investigate the clinical characteristics of orbital complications due to rhinosinusitis and to provide the basis for the diagnosis and treatment of this disease.MethodsRetrospectively analyzed the clinical data of 28 patients with orbital complications due to rhinosinusitis who were admitted into the Affiliated Hospital of Qingdao University,Department of Otorhinolaryngology from August 2009 to April 2017.In all 28 cases,there were 1 case with preseptal cellulites,9 cases with orbital cellulites,13 cases with subperiosteal orbital abscess and 5 cases with orbital abscess.Among all the patients,9 were younger than 14.Two patients were in ages from 14 to 17 and 7 patients were at or above 18 years.Absolute medicine therapy was performed on 8 patients and combined therapy of operation and pharmacotherapy on 20 patients.Results The patients were followed up for 2 to 19 months.Both the general symptoms and ocular symptoms disappeared and nasal ventilation function recovered well.Conclusions The treatment for orbital complications of rhinosinusitis includes absolute medicine therapy and combined therapy of operation and pharmacotherapy.And the selection of treatment depends on disease stage.Timely diagnosis and reasonable treatment would be beneficial in the recovery of patients.