摘要： 目的 探讨急性鼻窦炎并发眶骨膜下脓肿的诊断与治疗策略。方法 收集中国医科大学附属第一医院耳鼻咽喉科2019年2月至2022年12月收治的11例急性鼻窦炎并发眶骨膜下脓肿患者的临床资料，并进行分析总结。结果 急性鼻窦炎并发眶骨膜下脓肿的好发季节为春季和秋季。11例患者均为单侧病变，其中2例患者保守治疗，9例患者行鼻窦开放术及脓肿引流术，均治愈出院。患者的眼部症状中，眼球突出8例（72.7%），眼球活动受限5例（45.5%），视力下降4例（36.4%）。脓液培养阳性7例，其中，表皮葡萄球菌4例，星座链球菌2例，咽峡炎链球菌1例。结论 临床医生对急性鼻窦炎并发眶骨膜下脓肿患者应做到及时诊断，给予充分药物治疗的同时，注意眼部症状，把握手术时机。

急性鼻窦炎并发眶骨膜下脓肿的诊疗分析

张梦璐, 阎艾慧

中国医科大学附属第一医院耳鼻咽喉科, 沈阳 110001

收稿日期:2023-03-09出版日期:2023-07-30发布日期:2023-07-08
通讯作者:阎艾慧E-mail:yanmenxueshu@163.com
作者简介:张梦璐(1993-),女,医师,硕士研究生.
基金资助:辽宁省科学事业公益研究基金（20170058）


关键词: 急性鼻窦炎, 眶骨膜下脓肿, 眶并发症, 功能性内镜手术
Abstract: Objective To explore diagnostic and treatment strategies for acute sinusitis complicated by orbital subperiosteal abscess. Methods Clinical data from 11 patients with acute sinusitis complicated by orbital subperiosteal abscess，diagnosed at the Department of Otolaryngology，the First Hospital of China Medical University between February 2019 and December 2022，were analyzed and summarized. Results Seasonal disease prevalence was highest in the spring and autumn. Eleven patients exhibited unilateral lesions，in whom two improved after conservative treatment，and nine patients underwent sinus surgery and abscess drainage. Among ocular symptoms，eight （72.7%）patients exhibited exophthalmos，five（45.5%）expereinced limited eye movement，and four（36.4%）had decreased vision. Pus cultures were positive in seven patients：Staphylococcus epidermidis（n=4），Streptococcus constellatus（n=2），and Streptococcus angina （n=1）. Conclusion Clinicians should diagnose patients with acute sinusitis complicated by orbital subperiosteal abscess in a timely manner，devote attention to ocular symptoms，and take advantage of surgical opportunities while providing adequate drug treatment.
Key words: acute sinusitis, orbital subperiosteal abscess, orbital complication, functional endoscopic surgery
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