提上睑肌和Muller肌延长术治疗甲状腺相关眼病上睑退缩的疗效  

The Effect of Levator Muscle and Muller Muscle Prolongation Treatment of Thyroid Associated Upper Eyelid Retraction

作　　者：李妍 史俊虎 王娟 李荣荣 张宏彬 刘杉 

机构地区：[1]河北省眼科医院眼整形科,河北邢台054000

出　　处：《医学综述》2016年第13期2690-2692,共3页Medical Recapitulate

摘　　要：目的探讨提上睑肌和Muller肌延长术治疗甲状腺相关眼病上睑退缩的临床疗效。方法选取2013年1月至2015年1月河北省眼科医院接诊的甲状腺相关眼病上睑退缩患者108例(108眼),按照随机数字表法分为观察组和对照组,各54例(54眼)。观察组采用提上睑肌和Muller肌延长术治疗,对照组采用提上睑肌中央腱膜切断术治疗,观察比较两组患者治疗后的临床效果、满意率和各指标变化情况。结果治疗后两组患者上方巩膜露白和睑裂宽度均较治疗前显著下降,观察组显著低于对照组[(2.12±0.21)mm比(3.02±0.48)mm、(9.1±0.9)mm比(10.2±1.2)mm],差异有统计学意义(P<0.01);治疗后两组患者基础泪液分泌(SIT)、泪膜破裂时间(BUT)以及上睑覆盖角膜高度指标均较治疗前显著上升,观察组显著高于对照组[(8.2±2.1)mm/min比(6.9±2.0)mm/min、(5.8±2.1)s比(4.1±1.4)s、(2.56±0.45)mm比(2.01±0.21)mm],差异有统计学意义(P<0.01);治疗后,观察组有效率显著高于对照组[94.44%(51/54)比66.67%(36/54)],差异有统计学意义(P<0.05)。结论提上睑肌肉和Muller肌延长术治疗甲状腺相关眼病上睑退缩具有很好的临床疗效,值得在临床上推广使用。Objective To investigate the clinical efficacy of levator muscle and Muller muscle prolongation treatment of thyroid associated upper eyelid retraction. Methods Total of 108 patients（ 108 eyes） with thyroid related upper eyelid retraction in Hebei Ophthalmic Hospital from Jan. 2013 to Jan. 2015 were included in the study, according to the random number table method they were divided into an observation group and a control group ,54 eases （54 eyes） each. The observation adopted levator muscle and Muller muscle prolongation treatment, the control group adopted central tenotomy of levator muscle treatment, and the clinical effect, satisfaction rate and the index changes of the two groups were observed and compared. Results After treatment, scleral grin and palpebral width of both groups were significantly decreased from before treatment,the observation group was significantly lower than the control group [ （2. 12 ± 0.21 ） mm vs （3.02 ± 0. 48 ） mm, （9. 1 ± 0. 9） mm vs （ 10.2 ± 1.2 ） mm] , the differences were statistically significant （ P 〈 0. 01 ） ; after treatment, SIT, BUT and upper eyelid cover height were significantly increased, the observation group was significantly higher than the control group [ （ 8. 2 ± 2. 1 ）mm/min vs （6. 9 ± 2. 0 ） mm/min, （5.8 ±2. 1 ） s vs （4. 1 ± 1.4） s, （2. 56 ±0. 45 ）mm vs （2. 01±0. 21 ） mm] ,the differences were statistically significant（ P 〈 0.01 ）;after treatment, total efficacy of the observation group was significantly higher than control greup[94. 44% （51/54） vs 66. 67% （36/54） ] ,with statistically significant difference（P 〈 0.05 ）. Conclusion The levator muscle and Muller muscle prolongation treatment on thyroid related upper eyelid retraction has good clinical curative effect, and is worthy of application and promotion in clinical.

关 键 词：上睑退缩 提上睑肌 Muller肌延长术 甲状腺 

分 类 号：R722.3[医药卫生—儿科]