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摘要


目的:報告一例眼窩氣腫的病例以細針抽吸眼窩減壓術治療。 方法:個案報告及文獻回顧。 結果:一名十六歲男性右眼窩遭撞擊後,因反覆打噴嚏後出現眼窩氣腫,右眼視力在配戴眼鏡下仍可達6/6,但右眼瞼嚴重下垂而且眼壓達36亳米汞柱。眼窩部電腦斷層結果發現右眼窩眶內側骨折且有氣體進入眼窩內。三天後病人仍因眼窩氣腫導致的眼瞼下垂和眼壓持續偏高而感到不適,因此我們為其進行細針眼窩減壓手術。在右上眼瞼皮膚塗抹局部麻醉藥後,由助手於注射處兩邊往中間擠壓,使眼窩內氣體向中間頃起眼瞼,以方便進針抽吸。在抽出5毫升氣體後,病人右眼眼壓明顯下降至21毫米汞柱且可自行張開右眼。 結論:眼窩鈍銼傷患者,應建議避免用力打噴嚏而導致眼窩氣腫。細針抽吸眼窩減壓術可使患者的症狀及早獲得改善。

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並列摘要


Purpose: To present a case of orbital emphysema relieved by needle decompression. Method: Case report and literature review. Result: A 16-year-old male presented with acute onset of crepitant swelling of the right eyelids after an episode of sneezing. He had suffered a right orbital blunt trauma one day earlier. The intraocular pressure was 36 mm Hg in the affected eye. Orbital computed tomography (CT) scan disclosed subcutaneous emphysema of the right upper and lower lids communicating with extraconal air in the orbit. There was no significant improvement after 3 days of observation. Orbital needle decompression was undertaken through his right upper eyelid following topical anesthesia. There was instantaneous alleviation of ptosis and immediate relief from orbital tension. Conclusion: Avoidance sneezing is advised for patients with periorbital trauma. Needle decompression may provide an early and effective cure for orbital emphysema.

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