手术治疗眼肿瘤179例分析

Clinical analysis on 179 cases of ocular tumor

目的 分析 179例眼部肿瘤的临床特点、诊断及手术治疗方法及误诊情况。方法 按解剖部位 ,分为外眼、眼球内及眼眶内肿瘤 3组 ,根据肿瘤性质与部位的不同 ,采取针对性的检查与手术治疗 ,并予以总结归纳 ,对其中术后病理切片与术前诊断不符者 ,进行回顾性分析。结果 随访期 3年 ,外眼良性瘤疗效 10 0 % ;外眼恶性瘤中 1例黑色素瘤 ,1例鳞状细胞癌因转移而死亡 ,1例睑板腺癌术后复发 ,治愈率 70 %。眼内肿瘤中 ,1例视网膜母细胞瘤因全身转移术后死亡 ,治愈率 89% ,误诊率 14 2 8%。眼眶肿瘤中多发性视神经纤维瘤 2例术后复发 ,治愈率 85 82 % ,误诊率 13 3 3 %。结论 掌握了眼部肿瘤的临床特点 ,并依藉各种必要的检查技术 ,可以明确判断肿瘤的部位和性质 。

Objective To analyze the features,the method of diagnosis and treatment and misdiagnosis about ocular tumor.Methods Cases were divided into three patterns by anatomical position:extra ocular tumor,intra ocular tumor,orbital tumor.Especial measures of checking and treatment were taken according to different site and quality of eye tumor,and analysis was given.Cases with pathologic diagnosis different from preoperative was analyzed retrospectively.Results After three years follow up,the curative effectiveness of extra ocular benign tumor was 100%.In extra ocular malignant tumors one case of squamous cell carcinoma and one case of melanoma died because of metastasis,one case recurred after operation.The recovery rate was 70%.In intra ocular tumor,one case of retinoblastoma died because of general metastasis after operation,the recovery rate was 89%,misdiagnosis rate was 14.28%.Two cases of orbital tumor,multiple optic nerve fibromas recurred after operation,its recovery rate was 86.6%,misdiagnosis rate was 13.33%.Conclusion Oculists may clearly judge the site and quality of tumor and adopt effective treat plan if they master the site and quality of tumor by the routine and new examination.Retrospective analysis of misdiagnosis case can be useful for experience accumulation and the medical level improvement.