内容提要　33例因鼻源性疾病引起的眼部并发症中,眼球突出31例,复视18例,视力障碍(失明,光感、视力下降)10例,主要采取鼻外及鼻窦内窥镜下手术治疗。结果显示:术后眼球突出28例恢复原位(90.3%),18例复视消失 (100%);视力障碍10例中5例视力恢复至0.6～0.8,1例光感恢复至1m指数,1例术前失明恢复至光感,3例治疗无效。表明鼻部病变导致视力障碍的发病率在鼻眼相关疾病中较高,积极治疗鼻部原发病灶,特别是尽早对外伤引起的眶及筛蝶窦血肿进行手术,可减少视功能的损害。

　　关键词　鼻疾病;眼疾病;并发症

　　ANALYSIS OF THE RELATIVE FACTORS OF EYE DISEASE
ORIGINATED FROM NOSE:WITH A REPORT OF 33 CASES

　　Yin Fenglan　Yang Qiaoling

　　(The People′s Hospital of NingXia Hui Autonomous Region)

　　Abstract　Thirty-three cases of eye complication are originated in nose disease.Of them,31 cases showed exophthalmus;18 cases with diplopia;10 cases with blindness,light sensation and vision declining.Extranasal and intranasal operation were used with endoscope.The result indicated that 28 cases(90.3%)got reposition,18 cases got diplopia vanished(100%),5 cases improved vision to 0.6-0.8,1 case recovered light sensation to lm finger digit,1 case got light sensation,and 3 cases failed(30%).This draws a conclusion that the rate of failing vision caused by morbidity of nasal disease is rather high in the EDON,therefore,it is necessary to treat original fucus of nose and the hematoma of orbit and ethmosphenoid sinus early.

　　Key words　Nose diseases;Eye diseases; Complication

　　由鼻源性疾病引起眼球突出、视力障碍、眼肌麻痹等临床较常见,许多患者首诊于眼科。现对产生眼部并发症的相关因素及临床治疗方式探讨如下。

　　1　资料与方法

　　1.1　临床资料　本组33例中,男24例、女9例,5～70岁;病程3d～5年,其中18例首诊于眼科。33例中,左侧病变13例,右侧病变20例,全部病例均行CT检查,结果显示鼻部病变中筛窦囊肿19例,牙源性上颌窦炎并发眶蜂窝织炎6例,眶鼻联合骨折眶筛蝶窦血肿8例。术前行眼底检查,外伤8例视盘境界不清、水肿,网膜散在片状出血,中心窝光反射消失;6例眶蜂窝织炎可见视乳头水肿。术前眼部病变及视力障碍见表1。

　　表1　术前眼部病变及视力障碍情况
 
　　1.2　治疗方式　33例均由耳鼻喉科经鼻外途径和在鼻窦内窥镜下行囊肿摘除术或筛窦切除加眶纸板切除术,眶骨膜切开眶减压术;14例在鼻窦内窥镜下手术。

　　2　结　果

　　31例眼球突出中28例(90.3%)术后完全回位,3例眼球回位不理想,仍向前外突出5mm;18例(100%)复视消失;视力障碍10例中视力恢复及好转7例(70%);3例无效(30%)。随访6月～3年,术后结果见表2。

　　表2　术后眼部病变及视力改善情况

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