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目的 探讨眼眶炎性假瘤所致的眶尖综合征的临床特点和治疗等。方法 回顾分析我院自1 978年 1月到 1 998年 1 2月眼眶炎性假瘤病例 1 94例 ,其中 9例有典型的眶尖综合征表现 :患眼向各个方向运动受限或眼球固定 ,上睑下垂 ,调节麻痹 ,瞳孔散大 ,下睑皮肤麻木和视力下降或丧失等。治疗方法包括全身口服皮质激素、局部放射治疗、手术切除和上述方法联合治疗等。结果 9例病人中 ,6例有眼球突出 ,5例有眼眶疼痛与结膜或眼睑充血。 5例经全身激素治疗后 ,4例视力有提高 ;3例上睑下垂基本消失 ,2例睑裂部分开大 ;5例病人眼球运动均恢复正常。 4例经开眶手术活检后用全身激素治疗 ,1例视力恢复正常 ,上睑下垂消失 ,眼球运动恢复正常 ;3例病情无好转。结论 眼眶炎性假瘤是眶尖综合征的常见原因之一 ,约一半病人没有眼部疼痛与充血 ,全身激素治疗效果好 ,其与眼眶恶性淋巴瘤的鉴别诊断十分重要
Objective To investigate the clinical features and treatment of orbital apex syndrome caused by orbital inflammatory pseudotumor. Methods A retrospective analysis of our hospital from January 1978 to January 1998 99 cases of orbital inflammatory pseudotumor 1 94 cases, including 9 cases of typical orbital apex syndrome performance: the eye movement in all directions restricted or eyeball Fixed, ptosis, paralysis adjustment, mydriasis, lower eyelid skin numbness and loss of vision loss or so on. Treatment methods include systemic oral corticosteroids, local radiotherapy, surgical resection and the above combination therapy. Results Of the 9 patients, 6 had prominent eyes and 5 had orbital pain with conjunctival or eyelid congestion. 5 cases of systemic hormone therapy, 4 cases of visual acuity increased; 3 cases of ptosis disappeared, 2 cases of palpebral fissure part of the big; 5 cases of patients with eye movements returned to normal. Four patients underwent orbital surgery after biopsy with systemic hormonal therapy, 1 case of visual acuity returned to normal, ptosis disappeared, eye movement returned to normal; 3 cases no improvement. Conclusions Orbital inflammatory pseudotumor is one of the common causes of orbital apex syndrome. About half of the patients have no eye pain and hyperemia, and systemic hormonal therapy is effective. It is very important for the differential diagnosis of orbital malignant lymphoma