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眶内穿透性和残留异物——神经外科病例系列

Intraorbital Penetrating and Retained Foreign Bodies - A Neurosurgical Case Series.

作者信息

Szabo Bianca, Pascalau Raluca, Bartoè Dana, Bartos Adrian, Szabo Ioan

机构信息

Clinical Emergency County Hospital Cluj, Department of Ophthalmology, Cluj-Napoca, Romania.

出版信息

Turk Neurosurg. 2019;29(4):538-548. doi: 10.5137/1019-5149.JTN.24265-18.2.

Abstract

AIM

To present the particularities of the intraorbital foreign bodies from a neurosurgical perspective by summarizing the findings of a case series.

MATERIAL AND METHODS

A retrospective study was conducted including a consecutive series of 30 patients with intraorbital foreign bodies treated between 1999 and 2017. Statistical analysis was performed in order to characterize the factors that influence the location of the foreign bodies and the clinical signs.

RESULTS

The orbital trauma occurred mostly in working accidents. Multiple intraorbital foreign bodies were found in 23.3% of the patients. Metallic foreign bodies were seen in 66.6%, and 30% had wooden foreign bodies. Nonmetallic foreign bodies were significantly associated with displacement of the eyeball, palpebral oedema and upper lid ptosis. Posterior orbit location was associated with displacement of the eyeball and conjunctival hemorrhage. Intraconal location was associated with mydriasis and conjunctival hemorrhage. The posterior orbit was occupied by foreign bodies in 63% of the patients. The foreign bodies were in the extraconal compartment in 55.55% of the cases. Small foreign bodies tend to be retained in the anterior orbit while large ones tend to be retained in the posterior orbit.

CONCLUSION

The diagnosis and management of intraorbital foreign bodies must be tailored according to their type and location and to the clinical aspect of the patient.

摘要

目的

通过总结一系列病例的研究结果,从神经外科角度阐述眶内异物的特点。

材料与方法

进行一项回顾性研究,纳入1999年至2017年间连续收治的30例眶内异物患者。进行统计分析以确定影响异物位置及临床体征的因素。

结果

眼眶外伤多发生于工伤事故。23.3%的患者发现有多发性眶内异物。66.6%可见金属异物,30%有木质异物。非金属异物与眼球移位、眼睑水肿及上睑下垂显著相关。眶后位与眼球移位及结膜出血相关。眶内位与瞳孔散大及结膜出血相关。63%的患者异物位于眶后。55.55%的病例异物位于眶隔外间隙。小异物倾向于滞留在前眶,而大异物倾向于滞留在后眶。

结论

眶内异物的诊断和处理必须根据其类型、位置及患者的临床表现进行个体化。

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