内镜下经眶内壁眶减压术治疗甲状腺相关性眼病  

Endoscopic transethmoid orbital medial wall decompression for thyroid associated ophthalmopathy

作　　者：徐琳琳[1] 原新鹏 卢静 蒲蔚 周媛[1] 朱云梅 封霄 

机构地区：[1]淄博市中心医院眼科,山东255031 [2]淄博市市级机关医院眼科,山东255000

出　　处：《中华眼外伤职业眼病杂志》2017年第11期840-842,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价鼻内镜下经筛窦及眶内壁减压联合眶脂肪减压治疗甲状腺相关性眼病（TAO）的效果。方法回顾性分析TAO11例（17眼）的临床资料。患者均为眼球突出非组织活动期，内镜下行经筛窦及眶内壁眶减压联合脂肪减压手术，术后定期随访。结果术后6个月，眼球突出矫正度达（5．24±1．79）mm，与术前比较差异有统计学意义（P〈0．05），且术后双眼眼球突出度相差均〈2mm；术前角膜上皮异常者14眼（82．35％），术后减少为2眼（11．76％），差异有统计学意义（P〈0．05）；术后睑裂高度平均下降（2．59±0．48）mm，与术前比较差异有统计学意义（P〈0．05）。术后无视力下降或眶内出血等并发症发生。结论鼻内镜下眶内壁减压联合眶脂肪减压术治疗甲状腺相关性眼病效果良好。Objective To evaluate the efficacy of endoscopic transethmoid and orbital medial wall decompression combined with orbital fat decompression for thyroid associated ophthalmopathy （TAO）. Methods The data of 17 eyes of 11 patients with TAO were selected and retrospectively analyzed. They reeeieved endoscopic transethmoid and orbital medial wall decompression combined with orbital fat decompression. All patients were followed up periodically. Results Six months after surgery, the mean reduction in proptosis was （ 5.24 ＋- 1.79 ） ram, the difference was statistically significant between before and after surgery （ P 〈 0.05 ）. Postoperatively the difference of exophthalmos between the both eyes was within 2 mm. Corneal epithelial abnormalities decreesed from 14 eyes （82. 35% ） preoperative to 2 eyes （11.76%） postperative , the difference was statistically significant （P 〈 0. 05 ）. And postoperative mean height of palpebral fissure decreased （ 2.59 ± 0.48 ） mm, the difference was statistically significant （ P 〈 0.05）. There was no loss of visual acuity, orbital bleeding or other complication. Conclusion The endoscopic transethmoid orbital medial wall decompression combined with orbital fat decompression is an effective treatment for TAO.

关 键 词：眼病 甲状腺相关性 眶减压术 经筛窦 内窥镜下 

分 类 号：R581[医药卫生—内分泌] R779.6[医药卫生—内科学]