大型综合医院眼眶病专业门诊疾病谱分析及诊治经验

Analysis of the spectrum of orbital diseases and diagnosis and treatment experiences in large general hospital outpatient service

目的:观察眼眶病专业门诊患者疾病谱变化和疾病分布特点,介绍眼眶门诊疾病的诊治流程和方法;明确眼眶病专业的工作重点和社会需求。方法:前瞻性观察研究。设计登记表,记录本治疗组门诊眼眶病患者性别、年龄、门诊诊断。眼眶病共分为七大类,统计分析七大类疾病的构成比、男女比例、发病年龄,以及优势病种的亚类和前三位常见疾病。介绍本院眼眶病专业门诊的诊治流程。结果:2021-04-01/12-31本治疗组门诊登记眼眶病患者共1059例。最常见的是甲状腺相关眼病325例(30.7%),其他依次是眼眶肿瘤282例(26.6%)、眼眶外伤213例(20.1%)、眼眶炎症205例(19.4%),眼眶血管畸形、先天性和遗传性病和其他3类眼眶疾病共34例(3.2%)。病理诊断:眼眶肿瘤良性150例(72.8%),前三位分别是血管淋巴管瘤、眼眶囊肿和神经源性肿瘤;恶性56例(27.2%),前三位分别是眶淋巴瘤、泪腺腺样囊性癌和横纹肌肉瘤。眼眶外伤最常见的是眼眶爆裂骨折,其次是视神经损伤、眼眶软组织挫伤。眼眶炎症中非感染性占89.8%,感染性占10.2%。结论:眼眶病疾病谱有所变化,常见和优势病种依次是甲状腺相关眼病、眼眶肿瘤、眼眶外伤和眼眶炎症,共占96.8%,是眼眶病专业门诊医师的主要工作内容。应根据疾病谱变化合理配置眼眶病专业的医疗资源,适应社会发展需求。

AIM:To observe the changes of disease spectrum and characteristics of orbital disease distribution in orbital outpatients,introduce the procedures and methods of diagnosis and treatment of orbital diseases in our hospital and define the work focus and social needs in orbital disease.METHODS:Prospective observational study.A registration form was designed to record the gender,age and diagnosis of orbital outpatients in our treatment group.The orbital diseases were divided into seven categories for statistical analysis.The composition ratio,male to female ratio,age of onset,subtypes of dominant diseases and the top three common diseases were analyzed.This paper introduces the diagnosis and treatment process of the orbital disease specialty clinic of our hospital.RESULTS:A total of 1059 patients with orbital diseases were registered from April 1 to December 31,2021.The most common orbital diseases were thyroid-related ophthalmopathy(TAO)in 325 cases(30.7%),followed by orbital tumors in 282 cases(26.6%),orbital trauma in 213 cases(20.1%),orbital inflammation in 205 cases(19.4%).Orbital vascular malformation,congenital and genetic venereal diseases and other orbital diseases were 34 cases(3.2%).Pathological diagnosis:orbital tumors in 150 cases(72.8%)were benign,the first three benign tumors were hemolymphangioma,orbital cyst and neurogenic tumor.Orbital tumors in 56 cases were malignant(27.2%),the first three malignant tumors were orbital lymphoma,adenoid cystic carcinoma of the lacrimal gland and rhabdomyosarcoma.The most common orbital injury was orbital blowout fracture,followed by optic nerve injury and orbital soft tissue injury.Orbital non-infectious inflammation accounted for 89.8%and 10.2%with infectious inflammation.CONCLUSION:The spectrum of orbital diseases has changed,and the most common and dominant diseases are TAO,orbital tumor,orbital trauma and orbital inflammation,accounting for 96.8%of the total,which are the main work content in orbital profession.Medical resources of orbital diseases should be rationally allocated according to the changes of disease spectrum to meet the needs of social development.