欢迎来到《四川大学学报(医学版)》 2019年11月1日 星期五
梅芳, 陈娟, 钱晶, 等.儿童眶蜂窝织炎165例诊疗分析.四川大学学报(医学版),2019,50(2):256-259
儿童眶蜂窝织炎165例诊疗分析
Analysis of Diagnosis and Treatment of 165 Cases Pediatric Orbital Cellulitis
  
中文关键词:  眶隔前蜂窝织炎眶隔后蜂窝织炎静脉抗生素
英文关键词:Pre-septal orbital cellulitisPost-septal orbital cellulitisIntravenous antibiotics
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中文摘要:
      目的总结儿童眶蜂窝织炎的发病特征和治疗经验,为眶隔后蜂窝织炎与眶隔前蜂窝织炎的鉴别诊断及治疗提供临床依据。方法回顾性分析南京医科大学附属儿童医院2009年1月至2015年12月收治的165例眶蜂窝织炎患儿的临床资料,按病变部位分为眶隔前蜂窝织炎(139例)和眶隔后蜂窝织炎(26例)两组,比较两组间一般特征、发病诱因、临床特征、实验室检查及治疗情况等差异。结果眶隔前蜂窝织炎组患儿139例,眶隔后蜂窝织炎组患儿26例,眶隔后蜂窝织炎患儿平均年龄大于眶前隔蜂窝织炎患儿,而两组间性别比例相似,均为男性患儿多于女性患儿,诱因均以鼻窦炎为主。眶隔后蜂窝织炎患儿与眶隔前蜂窝织炎患儿相比发病年龄更大、病史更长、眼球固定、眼球突出比例更高、白细胞计数和C反应蛋白更高、抗生素使用时间更长、住院时间更长(P<0.05)。结论眶隔后蜂窝织炎与眶隔前蜂窝织炎相比更加隐匿、危害更大、全身反应更重、治疗时间更长;鉴别两者必须依靠CT检查,而非临床症状;静脉抗生素辅以适当手术疗效显著。
英文摘要:
      ObjectiveTo 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. MethodsRetrospectively 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. ResultsThe 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 (P<0.05). ConclusionsCompared 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.
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