【摘要】：目的探討鼻內(nèi)鏡手術(shù)所致眼部并發(fā)癥的處理方法。方法鼻內(nèi)鏡手術(shù)所致眼部并發(fā)癥32例,其中失明2例、復(fù)視伴視力下降5例、單純復(fù)視不伴視力下降25例。CT未見眶腔內(nèi)出血22例,行眶內(nèi)壁骨折修復(fù),直肌嵌夾松解術(shù);眶腔出血10例,2例失明者行開眶減壓、引流術(shù)、激素及神經(jīng)營養(yǎng)劑治療,3例單純復(fù)視伴眶腔內(nèi)出血和5例視力下降伴眶腔內(nèi)出血者,保守治療2周后行眶內(nèi)壁骨折修復(fù),直肌嵌夾松解術(shù)。結(jié)果 2例失明者中,1例術(shù)后4 d右眼光感(+),術(shù)后19 d~3個月視力0.3;另1例無效。30例眶內(nèi)壁骨折修復(fù),直肌嵌夾松解術(shù)后復(fù)視消失9例,17例有所緩解,4例無效;其中,8例保守治療后手術(shù)者,5例有所緩解,3例無效。結(jié)論應(yīng)積極、規(guī)范治療鼻內(nèi)鏡手術(shù)所致眼部并發(fā)癥,手術(shù)效果與眶壁骨折部位、直肌嵌夾損傷程度及手術(shù)時機有關(guān)。
[Abstract]:Objective to investigate the management of ocular complications caused by nasal endoscopic surgery. Methods 32 cases of ocular complications caused by nasal endoscopic surgery, including 2 cases of blindness, 5 cases of amblyopia with vision loss, 25 cases of simple diplopia without visual loss, 22 cases of no intraorbital hemorrhage on CT, were treated with repair of internal orbital wall fracture and relaxation of rectus muscle entrapment. Of the 10 cases of orbital hemorrhage, 2 cases were treated with orbital decompression, drainage, hormone and neurotrophic agents, 3 cases with simple diplopia with intraorbital hemorrhage and 5 cases with decreased vision with intraorbital hemorrhage. After 2 weeks of conservative treatment, orbital wall fractures were repaired. Relaxation of rectus muscle entrapment. Results among the 2 cases, the visual acuity of the right eye was 0.3 on the 19th day after (), on the 4th day after the operation, and the visual acuity was 0.3 at the 3rd month after the operation. In 30 cases of orbital internal wall fracture repair, 9 cases disappeared after operation, 17 cases were relieved, 4 cases were ineffective, among them, 8 cases underwent conservative treatment, 5 cases had remission and 3 cases had no effect, and the other 30 cases had no effect on orbital wall fracture, 9 cases had recuperation, 17 cases had remission and 4 cases had no effect after operation. Conclusion it is necessary to regulate the treatment of ocular complications caused by nasal endoscopic surgery. The operative effect is related to the site of orbital wall fracture, the degree of injury of rectus muscle entrapment and the timing of operation.
【作者單位】： 中國醫(yī)科大學附屬第一醫(yī)院;
【分類號】：R765.9;R779.6

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