传统三壁开眶减压术治疗严重甲状腺相关眼病.pdfVIP

中华n~外伤职业DIl病杂志 2015 年6 月第37 卷第6 期 Chin J ûcul Traum ûccupat Eve Dis 噜 Jun 2015 , Vol. 37 , No.6 , 461 • ·临床报道· 传统三壁开眶减压术治疗严重甲状腺 相关眼病 王俊何剑锋严宇清李凯军赵珍妮 {摘要] 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 ft!O 女 1 例(2 眼) ，眼球突出度 25 mm，眶压;;:::T+3 ，伴有暴露性角膜溃荡，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l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，角膜溃荡好转，险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。 【关键词】 甲状腺相关性D~病，严重;开O[减压术，三壁，传统;有效性;安全性 Traditional 也ree orbital wall decompr四:ion for severe thyroid-associated ophthaImopathy Wang Jun , He Jiar咖啄， Yan Yuqing ， μK呼un ， Zhω Zhenni. The Secoru1 People s Hospital 0/ Guilin , Guilin , Guangxi 5419∞， China Corre，写poru1ing author: He Jiar如g， Ernail: 问rza矿。 163. com [ Abstract] 0均创刊 To 伽erve the clinical e伍c町 and safety of 甘aditio叫出ree 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 comeal ulcer and sharp decline of vision caused by optic nerve compression. They were treated with traditional three orbital wall decompression. 白le 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 b