Mei Fang, Chen Juan, Qian Jing, Chen Zhi-Jun
Department of Ophthalmology, Children's Hospital Affiliated to Nanjing Medical University, Nanjing 210008, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2019 Mar;50(2):256-259.
To summarize the characteristics and treatment experience of orbital cellulitis in children, and to provide clinical basis for the diagnosis and treatment of pre-septal orbital cellulitis and post-septal orbital cellulitis.
Retrospectively analyzed 165 cases of orbital cellulitis in Children's Hospital Affiliated to Nanjing Medical University from January 2009 to December 2015. According to the location of lesions, the array was divided into two groups: pre-septal orbital cellulitis (139 cases) and post-septal orbital cellulitis (26 cases). The difference in general characteristics, pathogenesis, clinical characteristics, laboratory examination and treatment were compared between two groups.
The sex ratio between the two groups was similar, with more male children than female. The main predisposing factors were also sinusitis. Compared with children with pre-septal orbital cellulitis, children with post-septal orbital cellulitis had older onset age, longer medical history, more fixed eyeball and exophthalmos. Higher leukocyte count and C-reactive protein, longer antibiotic use and longer hospital stay, with differences significant (<0.05).
Compared with pre-septal orbital cellulitis, post-septal orbital cellulitis is more concealed and harmful, with graver systemic reaction and longer treatment time. Not clinical symptoms but CT examination is more reliable in differential diagnosis. Intravenous antibiotics combined with appropriate surgery has a significant effect.
总结儿童眼眶蜂窝织炎的特点及治疗经验，为眶隔前蜂窝织炎和眶隔后蜂窝织炎的诊治提供临床依据。
回顾性分析2009年1月至2015年12月南京医科大学附属儿童医院收治的165例眼眶蜂窝织炎患儿。根据病变部位将患儿分为两组：眶隔前蜂窝织炎组（139例）和眶隔后蜂窝织炎组（26例）。比较两组患儿的一般特征、发病机制、临床特点、实验室检查及治疗情况。
两组患儿性别比例相近，男性患儿多于女性。主要诱发因素均为鼻窦炎。与眶隔前蜂窝织炎患儿相比，眶隔后蜂窝织炎患儿发病年龄较大，病程较长，眼球固定及眼球突出更明显。白细胞计数及C反应蛋白更高，抗生素使用时间及住院时间更长，差异有统计学意义（<0.05）。
与眶隔前蜂窝织炎相比，眶隔后蜂窝织炎更隐匿、危害更大，全身反应更严重，治疗时间更长。鉴别诊断时CT检查比临床症状更可靠。静脉应用抗生素联合适当手术治疗效果显著。
