曲安奈德半球后注射治疗甲状腺相关眼病.docVIP

曲安奈德半球后注射治疗甲状腺相关眼病[摘 要] 目的 评价曲安奈德半球后注射治疗甲状腺相关眼病的临床效果。方法 对28例48 眼甲状腺相关眼病患者以曲安奈德20mg加2%利多卡因0.5ml患眼行半球后注射，每2周1次，连续注射5次为一疗程，1月、3月后随访观察记录自觉症状、眼征情况。结果 26例自觉症状明显改善，眼球回退率84.5%，睑裂宽度缩小率87.5%，视力改善率82.9%，眼球运动障碍、复视、斜视改善率85.7%。结论 曲安奈德半球后注射治疗甲状腺相关眼病效果明显，毒副作用小，安全可靠。 关键词：曲安奈德 甲状腺相关眼病 半球后注射 Treatment of thyroid related ophthalmopathy by half-peribulbar injection of triamcinolone acetonide Chen Yu, Qin Yunfeng, Lang Yujing, Zhang Pingyun, The central hospital of XinXiang, XinXiang, China, 453000 [Abstract] Objective To assess the clinical effects of half-peribulbar injection of triamcinolone acetonide for thyroid related ophthalmopathy. Methods Half-peribulbar injection of tramcinolone acetonide (20 mg) with 2% Lidocaine (0.5 ml) for 28 cases (48 eyes), once every two weeks for five times as one period of therapy, and after 1 month, 3 months, the self symptoms and ocular signs were recorded and analyzed. Results 26 cases? self symptoms were improved with eyeball retraction 84.5%, eyelid width reduction 87.5%, vision improvement 82.9%, eye movement, strabismus, and diplopia improvement 85.7%, compared with those before the treatment. Conclusions Half-peribulbar injection of triamcinolone acetonide can effectively improve the symptoms and signs of thyroid related ophthalmopathy with fewer side effects, so it is a feasible and effective method for treating thyroid related ophthalmopathy. [Keywords] triamcinolone acetonide, thyroid related ophthalmopathy, half-peribulbar injection 中图分类号：R581 文献标识码：B 文章编号：1005-0019（2008）3-0078-02 甲状腺相关眼病又称Graves眼病，它包括甲亢型Graves眼病和眼型Graves病，是临床上成人最为常见的眼眶疾病，约占20%[1]。该病多见于青壮年，可引起眼胀、眼疼、畏光、流泪、复视、视力下降等自觉症状，出现眼睑退缩、迟滞、睑裂闭合困难、结膜充血水肿、眼球突出、斜视、眼球运动障碍、暴露性角膜炎等眼征，严重影响视功能和美观。传统治疗多采用全身糖皮质激素冲击或应用抗代谢药物治疗，虽具有一定的疗效，但因许多患者不能耐受其严重的毒副作用而被迫中止治疗[2]。2002年来我们对Graves眼病28例48眼患者给予半球后注射曲安奈德(triamcinolone acetonide，TA)取得了一定疗效，现报告如下： 1 材料及方法 1.1 一般资料 本组28例48眼，男13例23眼，女，15例25眼，年龄23～61岁，平均35岁，病程2个月至2年。其中甲亢型Graves眼病20例35眼，眼型Graves病8例13眼，眼部B超或CT均已排除眶内占位性病变、炎性假瘤等其他引