四种手术入路对眼眶深部海绵状血管瘤患者的影响

Effects of four surgical approaches on patients with deep cavernous hemangioma of the orbit

摘要:

目的：探讨经结膜入路、外侧入路、皮肤入路及外侧联合内侧结膜入路对眼眶深部海绵状血管瘤患者视力、肿瘤残余率及并发症的影响。

方法：眼眶深部海绵状血管瘤患者114例，根据手术入路分为A组(30例，经结膜入路)、B组(34例，经外侧入路)、C组(27例，经皮肤入路)及D组(23例，经外侧联合内侧结膜入路)，比较四组患者视力改善效果、肿瘤残余率及术后并发症。

结果：四组患者视力改善效果无差异(P=0.918)。A组、B组、C组及D组患者术后肿瘤残余率分别为0、2.9%、3.7%、0(P>0.05)。四组患者术后并发症发生率无差异(P=0.244)。

结论：根据眼眶深部海绵状血管瘤适应证，合理选择微创手术入路均可有效维持正常视力水平，且安全性均一致。

Abstract:

AIM: To investigate the effects of conjunctival approach, lateral approach, skin approach and lateral medial conjunctival approach on visual acuity, tumor residual rate and complications in patients with deep cavernous hemangioma of the orbit.

METHODS: Totally 114 patients with deep cavernous hemangioma of the orbit were divided into group A(30 cases, conjunctival approach), group B(34 cases, translateral approach)and group C(27 cases, transcutaneous)according to the surgical approach. The approach and the D group(23 cases, combined with the medial conjunctival approach via the lateral side), compared the visual acuity improvement effect, tumor residual rate and postoperative complications in the four groups.

RESULTS: There was no difference in visual acuity improvement between the four groups(P=0.918). The residual tumor rates of patients in group A, group B, group C and group D were 0, 2.9%, 3.7%, and 0, respectively. There was no difference in the incidence of postoperative complications between the four groups(P=0.244).

CONCLUSION: According to the indications of deep cavernous hemangioma of the orbit, the reasonable choice of minimally invasive surgery can effectively maintain the normal visual acuity level and the safety is consistent.