两种术式矫正甲状腺相关眼病上睑退缩的临床研究  

Correction of upper eyelid retraction in patients with thyroid -associated-ophthalmopathy

作　　者：易文殊[1] 许雪亮[2] 鲍婕[2] 

机构地区：[1]武警福建总队医院眼科,福州350003 [2]中南大学湘雅医院眼科,长沙410078

出　　处：《武警医学》2004年第8期592-594,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的　采用两种术式矫正静止期甲状腺相关眼病上睑退缩并观察其临床疗效。方法　将 2 5例 (35眼 )静止期甲状腺相关眼病上睑退缩患者随机分为A、B两组。A组 (15例 2 1眼 )采用Mullers’肌切除联合提上睑肌腱膜部分切断术治疗 :B组 (10例 14眼 )采用异体巩膜提上睑肌延长术治疗。术后随访 6个月 ,评价其临床疗效。结果　两组患者术后自觉症状均不同程度减轻或消失 ,术后睑裂高度与术前比均有显著性差异 (A组 ,P <0 .0 1;B组 ,P <0 .0 1)。在术后 6月 ,两组病例眼睑回退量比较 ,存在显著差异 (P <0 .0 5 )。A组 5例 7眼欠矫 ,4例 4眼存在颞侧巩膜暴露 ,无 1例过矫 ,术后 6月有 6例 8眼眼睑退缩复发。B组 2例 2眼术后 6月出现眼睑退缩复发 ,1例 1眼轻度过矫。结论　两种术式均可矫正静止期甲状腺相关眼病上睑退缩 ,且各有优缺点。Objective To evaluate the clinical effect of correcting upp e r eyelid retraction in patients with inactive thyroid-associated-ophthalmopath y by two surgical methods.Methods Twenty-five patients (35 eye s) with inactive thyroid-associated-ophthalmopathy were recruited. All patient s had a typical manifestation of upper eyelid retraction.The patients were divi ded into two groups.Fifteen patients (21 eyes) in the group A were treated by Mulllers' muscle excision combined with partial tenotomy of levator apon eurosis.Ten patients (14 eyes) in the group B were treated by lengthening of l evator muscle with scleral graft. The clinical effect was investigated in a b-m onth follow-up study.Results All patients reported a subjectiv e improvement in appearance and symptom.In group A, 5 patients (7 eyes) were und ercorrected; 4 patients (4 eyes) had lateral flare.But none of the patients in g roup A was overcorrected. Recurrent retraction occurred in 6 patients (8 eyes) six months after surgery. In group B, recurrent retraction occurred in 2 patient s (2 eyes ) six months after surgery and overcorreetion occurred in 1 patients (1 eye).Conclusion Both methods are effective in correcting upper eyelid retraction. Both methods have merits and demerits of their own.

关 键 词：矫正 甲状腺相关眼病 上睑退缩 外科治疗 Mullets’肌切除术 提上睑肌腱膜部分切断术 

分 类 号：R777.1[医药卫生—眼科]