中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
Chinese Journal of ocular trauma and occupational eye disease
2015年
6期
461-464
,共4页
王俊%何剑锋%严宇清%李凯军%赵珍妮
王俊%何劍鋒%嚴宇清%李凱軍%趙珍妮
왕준%하검봉%엄우청%리개군%조진니
甲状腺相关性眼病,严重%开眶减压术,三壁,传统%有效性%安全性
甲狀腺相關性眼病,嚴重%開眶減壓術,三壁,傳統%有效性%安全性
갑상선상관성안병,엄중%개광감압술,삼벽,전통%유효성%안전성
Ophthalmopathy,thyroid-associated,severe%Decompression,three orbital wall,traditional%Efficacy%Safety
目的 观察传统三壁开眶减压术治疗严重甲状腺相关眼病的临床疗效及安全性.方法 我院住院诊治的严重甲状腺相关性眼病6例(9眼)中男5例(7跟)女1例(2眼),眼球突出度＞ 25 mm,眶压≥T+3,伴有暴露性角膜溃疡,视神经压迫视力急剧下降,行传统三壁开眶减压术.对手术前、手术后1周及3个月的视力、眼压、眶压、眼球突出度、VEP、眼球运动度、眼底情况、眼外观情况及CT结果等临床指标进行观察对比,对并发症进行分析.评价传统三壁开眶减压术治疗严重甲状腺相关眼病的有效性及安全性.结果 手术后6眼视力提高,3眼保持不变;7眼眼压降低,下降范围1 ～26 mmHg(1 mmHg =0.133 kPa),2眼眼压不变;眼球突出后退4～9 mm,平均(6.17±2.03)mm;所有患者眶压都降低,角膜溃疡好转,睑裂闭合不全者术后闭合明显改善,眼球运动度好转,眼底无改变,外观满意,术后CT显示眼眶减压良好.结论 通过各项临床指标的分析显示传统三壁开眶减压术是临床用于治疗严重甲状腺相关眼病的手术方法,没有与该手术方法相关的严重的并发症的发生,它能有效扩大眼眶容积,缓解眼球突出,改善外观,明显降低眶压,是治疗严重甲状腺相关眼病的一种有效安全的手术方式,特别是对威胁视力的甲状腺眼病效果更为显著.
目的 觀察傳統三壁開眶減壓術治療嚴重甲狀腺相關眼病的臨床療效及安全性.方法 我院住院診治的嚴重甲狀腺相關性眼病6例(9眼)中男5例(7跟)女1例(2眼),眼毬突齣度＞ 25 mm,眶壓≥T+3,伴有暴露性角膜潰瘍,視神經壓迫視力急劇下降,行傳統三壁開眶減壓術.對手術前、手術後1週及3箇月的視力、眼壓、眶壓、眼毬突齣度、VEP、眼毬運動度、眼底情況、眼外觀情況及CT結果等臨床指標進行觀察對比,對併髮癥進行分析.評價傳統三壁開眶減壓術治療嚴重甲狀腺相關眼病的有效性及安全性.結果 手術後6眼視力提高,3眼保持不變;7眼眼壓降低,下降範圍1 ～26 mmHg(1 mmHg =0.133 kPa),2眼眼壓不變;眼毬突齣後退4～9 mm,平均(6.17±2.03)mm;所有患者眶壓都降低,角膜潰瘍好轉,瞼裂閉閤不全者術後閉閤明顯改善,眼毬運動度好轉,眼底無改變,外觀滿意,術後CT顯示眼眶減壓良好.結論 通過各項臨床指標的分析顯示傳統三壁開眶減壓術是臨床用于治療嚴重甲狀腺相關眼病的手術方法,沒有與該手術方法相關的嚴重的併髮癥的髮生,它能有效擴大眼眶容積,緩解眼毬突齣,改善外觀,明顯降低眶壓,是治療嚴重甲狀腺相關眼病的一種有效安全的手術方式,特彆是對威脅視力的甲狀腺眼病效果更為顯著.
목적 관찰전통삼벽개광감압술치료엄중갑상선상관안병적림상료효급안전성.방법 아원주원진치적엄중갑상선상관성안병6례(9안)중남5례(7근)녀1례(2안),안구돌출도＞ 25 mm,광압≥T+3,반유폭로성각막궤양,시신경압박시력급극하강,행전통삼벽개광감압술.대수술전、수술후1주급3개월적시력、안압、광압、안구돌출도、VEP、안구운동도、안저정황、안외관정황급CT결과등림상지표진행관찰대비,대병발증진행분석.평개전통삼벽개광감압술치료엄중갑상선상관안병적유효성급안전성.결과 수술후6안시력제고,3안보지불변;7안안압강저,하강범위1 ～26 mmHg(1 mmHg =0.133 kPa),2안안압불변;안구돌출후퇴4～9 mm,평균(6.17±2.03)mm;소유환자광압도강저,각막궤양호전,검렬폐합불전자술후폐합명현개선,안구운동도호전,안저무개변,외관만의,술후CT현시안광감압량호.결론 통과각항림상지표적분석현시전통삼벽개광감압술시림상용우치료엄중갑상선상관안병적수술방법,몰유여해수술방법상관적엄중적병발증적발생,타능유효확대안광용적,완해안구돌출,개선외관,명현강저광압,시치료엄중갑상선상관안병적일충유효안전적수술방식,특별시대위협시력적갑상선안병효과경위현저.
Objective To observe the clinical efficacy and safety of traditional three orbital wall decompression for patients with severe thyroid-associated ophthalmopathy.Methods Nine eyes of 6 patients with severe thyroid associated ophthalmopathy were collected.Whose exophthalmos were over 25 mm or orbital pressure were more than T + 3, with exposed corneal ulcer and sharp decline of vision caused by optic nerve compression.They were treated with traditional three orbital wall decompression.The changes of vision, intraocular pressure, orbital pressure, degree of exophthalmos and proptosis, restrictions in eye movement, VEP, fundus clinical general appearance, CT results, diplopia, and complications were observed and compared before surgery, one week and three months after surgery.The clinical efficacy and safety of traditional three orbital wall decompression surgery for severe thyroid associated ophthalmopathy were evaluated.Results After the operation, the visual acuity was improved in six eyes, and remained unchanged in 3 eyes.The intraocular pressure decreased by 1-26 mmHg (1 mmHg =0.133 kPa) in seven eyes, and remained unchanged in 2 eyes.The recession of exophthalmos ranged from 4 mm to 9 mm, average (6.17 ± 2.03)mm.The pressure within the orbit was reduced significantly in all cases.Corneal ulcers became better and the lagophthalmopathy was improved significantly.Post-operative general appearance was satisfactory in all subjects.Postoperative CT images showed good results of orbital pressure decompression.Conclusion For severe thyroid-associated ophthalmopathy, traditional three orbital wall decompression is effective and safe, as shown by our analysis using clinical indicators.It is safe and effective in the expansion of orbital volume validitiy, reduction in proptosis, improvement in appearance, and lowering orbital pressure.No serious complications were found.
