中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2015年
11期
904-908
,共5页
时文杰%孙丰源%唐东润%张雅娜%简天明
時文傑%孫豐源%唐東潤%張雅娜%簡天明
시문걸%손봉원%당동윤%장아나%간천명
Graves眼病%减压术,外科%内窥镜检查%鼻外科手术
Graves眼病%減壓術,外科%內窺鏡檢查%鼻外科手術
Graves안병%감압술,외과%내규경검사%비외과수술
Graves ophthalmopathy%Decompression,surgical%Endoscopy%Nasal surgical procedures
目的 探讨重度Graves’眼病的内镜下平衡眶减压手术方法及其疗效.方法 对2010年7月至2014年6月天津市第一中心医院收治的6例12眼明确诊断为重度Graves'眼病并严重影响视觉功能及容貌的患者行平衡眶减压手术,即内镜下眼眶内、下壁减压术+眼外侧开眶减压术.观察手术前后患者的视力、眼球突出度、眶内容积、平均睑裂高度、眶内压等指标.应用SPSS 16.0软件对数据进行统计学分析.结果 术后随访12 ～ 28个月,患者的视力、眼球突出度、眶内容积、平均睑裂高度分别从术前的(0.23 ±0.08)、(22.08±1.08) mm、(26.84±0.62) cm3、(12.03±0.91)mm,改善为术后1年的(0.48±0.13)、(15.67±1.44) mm、(31.56±1.10) cm3、(8.62±0.75) mm,差异有统计学意义(t值分别为-5.749、17.924、-16.567、9.600,P值均＜0.001),术后眶内压较术前降低,差异有统计学意义(t值分别为-6.759、-11.850、-6.189,P值均＜0.001).术后3例患者出现复视,均于术后3～5个月后消失.结论 鼻内镜下平衡眶减压术可能是治疗重度Graves'眼病的有效方法之一.
目的 探討重度Graves’眼病的內鏡下平衡眶減壓手術方法及其療效.方法 對2010年7月至2014年6月天津市第一中心醫院收治的6例12眼明確診斷為重度Graves'眼病併嚴重影響視覺功能及容貌的患者行平衡眶減壓手術,即內鏡下眼眶內、下壁減壓術+眼外側開眶減壓術.觀察手術前後患者的視力、眼毬突齣度、眶內容積、平均瞼裂高度、眶內壓等指標.應用SPSS 16.0軟件對數據進行統計學分析.結果 術後隨訪12 ～ 28箇月,患者的視力、眼毬突齣度、眶內容積、平均瞼裂高度分彆從術前的(0.23 ±0.08)、(22.08±1.08) mm、(26.84±0.62) cm3、(12.03±0.91)mm,改善為術後1年的(0.48±0.13)、(15.67±1.44) mm、(31.56±1.10) cm3、(8.62±0.75) mm,差異有統計學意義(t值分彆為-5.749、17.924、-16.567、9.600,P值均＜0.001),術後眶內壓較術前降低,差異有統計學意義(t值分彆為-6.759、-11.850、-6.189,P值均＜0.001).術後3例患者齣現複視,均于術後3～5箇月後消失.結論 鼻內鏡下平衡眶減壓術可能是治療重度Graves'眼病的有效方法之一.
목적 탐토중도Graves’안병적내경하평형광감압수술방법급기료효.방법 대2010년7월지2014년6월천진시제일중심의원수치적6례12안명학진단위중도Graves'안병병엄중영향시각공능급용모적환자행평형광감압수술,즉내경하안광내、하벽감압술+안외측개광감압술.관찰수술전후환자적시력、안구돌출도、광내용적、평균검렬고도、광내압등지표.응용SPSS 16.0연건대수거진행통계학분석.결과 술후수방12 ～ 28개월,환자적시력、안구돌출도、광내용적、평균검렬고도분별종술전적(0.23 ±0.08)、(22.08±1.08) mm、(26.84±0.62) cm3、(12.03±0.91)mm,개선위술후1년적(0.48±0.13)、(15.67±1.44) mm、(31.56±1.10) cm3、(8.62±0.75) mm,차이유통계학의의(t치분별위-5.749、17.924、-16.567、9.600,P치균＜0.001),술후광내압교술전강저,차이유통계학의의(t치분별위-6.759、-11.850、-6.189,P치균＜0.001).술후3례환자출현복시,균우술후3～5개월후소실.결론 비내경하평형광감압술가능시치료중도Graves'안병적유효방법지일.
Objective To determine the efficacy of endoscopic transnasal orbital balanced decompression technique for the treatment of severe Graves' orbitopathy.Methods Six cases (12 eyes) of severe Graves'orbitopathy were included in this study.All patients were undergone endoscopic transnasal orbital balanced decompression technique (orbital inner and lower wall decompression + lateral orbital decompression) for severe Graves' orbitopathy and serious affecting visual function or appearance.Results The follow-up ranged from 12 months to 2 years and 4 months.Postoperatively, the visual acuity markly improved from 0.23 ±0.08 to 0.48 ±0.13 (t =-5.749, P ＜0.001).Proptosis measured by exophthalmoter distictly reduced from (22.08 ± 1.08) mm to (15.67 ± 1.44) mm (t =17.924, P ＜ 0.001).The palpebral fissures obviously reduced from (12.03 ± 0.91) mm to (8.62 ± 0.75) mm(t =9.600, P ＜ 0.001), and orbital volume evidently increased from (26.84 ± 0.62) cm3 to (31.56 ± 1.10) cm3 (t =-16.567, P ＜ 0.001).Compared with the preoperative result, the orbital pressure was significantly decreased after operation (t =-6.759 (Y =100 g), t =-11.850 (Y =200 g), t =-6.189 (Y =300 g), P ＜ 0.001).Diplopia was appeared in 3 cases, and disappeared 3 to 5 months after surgery.Conclusion Endoscopic transnasal orbital balanced decompression technique is effective for the treatment of severe Graves' orbitopathy.
