儿童鼻源性眶并发症的治疗策略

Treatment strategy of nasal orbital complications in children

目的:探讨儿童鼻源性眶并发症的治疗策略。方法:对大连市妇女儿童医疗中心耳鼻咽喉科2018年2月—2021年2月收治的28例鼻源性眶并发症患儿的临床资料进行分析和总结。结果:28例患儿中,眶蜂窝织炎16例,眶骨膜下脓肿10例,眶内脓肿1例,海绵窦血栓静脉炎1例。16例眶蜂窝织炎患儿中2例行手术治疗,10例眶骨膜下脓肿患儿中4例行手术治疗,1例眶内脓肿和1例海绵窦血栓静脉炎患儿均行手术治疗。所有患儿均治愈,临床随访均超过半年,未出现复发。结论:鼻源性眶并发症以眶蜂窝织炎最为常见,经3-7 d保守治疗后绝大多数患儿可获得良好效果,一旦出现视力进行性下降、感染加重、眼球运动障碍等症状时,应积极考虑手术治疗,手术时机选择对预后十分重要。

Objective: The aim of this study is to explore the treatment strategy of children’s nasal orbital complications. Methods: The clinical data of 28 children with nasal orbital complications admitted to Dalian Children’s Hospital from February 2018 to February 2021 were analyzed and summarized. Results: Among the 28 children, 18 were males(64.3%), 10 females(35.7%), 16 cases of orbital cellulitis, 10 cases of orbital subperiosteal abscess, 1 case of intraorbital abscess, and 1 case of cavernous sinus thrombophlebitis. Of the children with orbital cellulitis, 2 cases were treated with surgery, 4 cases with orbital subperiosteal abscess were treated with surgery, and the children with intraorbital abscess and cavernous sinus thrombophlebitis were treated with surgery. All the children were cured, and the clinical follow-up was more than half a year. No recurrence occurred. Conclusion: Periorbital cellulitis is the most common type of orbital complications. After conservative treatment(3—7 days), most children can get good results. Once the visual acuity is progressively decreased, the infection becomes worse, the eyeball movement disorder and other symptoms occur at this time, surgical treatment should be actively considered, and the timing of surgery is very important for the prognosis.