目的:探讨鼻内镜下眶壁部分切除治疗急性鼻源性眶骨膜下脓肿的治疗方法。方法:在全身应用头孢他啶及万古霉素24 h后,全身麻醉下行病侧上颌窦、筛窦开放术,同时取鼻窦内脓性分泌物做细菌培养及药物敏感试验;对影响鼻窦引流或术后鼻腔清理的鼻中隔偏曲、肥大中鼻甲同期或择期进行处理;术后24 h取出鼻腔填塞物,吸引器每日2次清理术腔渗出物,直至有新鲜肉芽组织完全覆盖创面;对于有细菌培养结果及药物敏感性者,更换抗生素,对于无结果者,继续应用头孢他啶及万古霉素5 d。结果:全部患者未出现眶部、鼻腔、颅内及全身并发症,术后24~48 h体温恢复正常,眼痛、眼胀、头痛症状明显改善,睑、球结膜水肿消腿明显,眼球活动度明显增加;术后13~22 d,全部患者眼部体征恢复正常,随访6个月无复发,6例遗有间断性眼部胀痛感。结论:鼻内镜下眶壁部分切除治疗急性鼻源性眶骨膜下脓肿是安全性高、疗效显著,具有明显优点的治疗方式。 Objective: To explore the treatment of acute nasal orbital subperiosteal abscess under endoscopic orbital partial resection. Methods: After systemic ceftazidime and vancomycin were given for 24 hours, the maxillary sinus and ethmoid sinus were opened under general anesthesia and the bacterial culture and drug sensitivity test were performed on the purulent secretions of the sinuses. Nasal septum deflection, hypertrophy of middle turbinate same period or elective treatment; 24 h after removal of nasal stuffing, aspirator 2 times a day to clear the exudate until the fresh granulation tissue completely cover the wound; for bacteria To develop results and drug sensitivity, replace antibiotics, continue ceftazidime and vancomycin for 5 days if there is no result. Results: No orbital, nasal cavity, intracranial and systemic complications occurred in all patients. The body temperature returned to normal within 24-48 hours after operation, and the symptoms of eye pain, eye swelling and headache were significantly improved. The eyelids and conjunctival edema were significantly reduced and the eye movements Degree increased significantly; all eyes and signs of the patients returned to normal after 13-22 days, and no recurrence occurred 6 months after follow-up. Six cases had intermittent ocular pain sensation. Conclusion: Endoscopic orbital partial resection for the treatment of acute nasal orbital subperiosteal abscess is safe, significant effect, with obvious advantages in treatment.