曲安奈德眶周注射治疗甲状腺相关眼病的临床疗效分析  

Triamcinolone acetonide peri-orbit clinical curative effect analysis of periocular injection in treatment of thyroid related ophthalmopathy

作　　者：方莹 FANG Ying(Department of Ophthalmology Zhengzhou the Second People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第二人民医院眼科,郑州450000

出　　处：《医药论坛杂志》2020年第2期63-67,共5页Journal of Medical Forum

摘　　要：目的分析曲安奈德眶周注射治疗甲状腺相关眼病的临床疗效。方法收集2017年9月-2019年1月就诊于郑州市第二人民医院眼科,根据NOSPECS分级标准确诊为甲状腺相关眼病(TAO)Ⅱ级至Ⅴ级的患者65例,119眼。予以曲安奈德注射液20 mg、地塞米松注射液2.5 mg及利多卡因0.1 mL混合注射。随访观察治疗情况。结果治疗后视力改善率93.5%。治疗前眼压平均(14.361±3.502) mm Hg,治疗后眼压(14.071±3.298) mm Hg,无明显变化,差异无统计学意义(P>0.05)。眼球突出度治疗前(16.420±2.815)mm,治疗后(15.214±2.603)mm,比较有明显差异(P<0.05)。平视睑裂治疗前(10.626±1.577)mm,治疗后(9.517±1.235)mm,比较有明显差异(P<0.05)。上睑迟落症状好转率26.8%。治疗前上睑退缩平均(1.849±0.797)mm,睑闭合不全平均为(2.088±1.182)mm,治疗后分别(0.504±0.870)mm、(0.500±0.501)mm,均有明显改善(P<0.05)。眼睑肿胀、结膜充血、结膜水肿及泪阜水肿各项炎症表现情况治疗后明显好转,P值均<0.05。治疗后自觉症状(畏光、流泪、眼胀、异物感)较治疗前统计学差异显著,P值均<0.05。眼球运动评分由治疗前平均(-4.317±3.164)分,降到治疗后(-2.228±2.359)分,差异有统计学意义(P<0.05)。复视好转率为82.6%。角膜病变者治疗有效率57.1%。治疗前CAS评分为(2.160±1.228)分,治疗后测得评分为(0.832±0.857)分,比较有明显差异(P<0.05)。65例患者有4例出现眼压升高,无其他副作用出现。结论曲安奈德眶周注射治疗TAO,能有效改善视力、眼球突出度、眼球运动、复视、眼睑征、角膜病变,减轻炎症刺激症状、自觉症状;同时显著降低了TAO活动性评分,减轻炎症反应;并发症相对较少,是一种相对安全有效的治疗TAO的方法。Objective To analyze the clinical effect of periorbital injection of triamcinolone acetonide in the treatment of thyroid-related eye disease.Methods Collection between September 2017 and January 2019 clinic medical university part ophthalmic clinic, patients diagnosed with TAO. According to NOSPECS classification standard, the levels Ⅱ to Ⅴ patients in observation group therapy, a total of 65 cases, 119 eyes. Triamcinolone acetonide injection 20 mg and dexamethasone injection 2.5 mg and 0.1 mL lignocaine injections, drug injection to the surface of orbital space, muscles. Interval of 2 ~ 3 weeks injection again, four for a period of treatment. Follow-up was conducted to observe the therapeutic effect.Results The rate of visual improvement after treatment was 93.5%.Intraocular pressure on average before treatment is(14.361±3.502) mm Hg,after treatment is(14.071±3.298) mm Hg.Exophthalmos degree(16.420±2.815) mm Hg prior to treatment, after treatment for(15.214 ± 2.603) mm Hg, compared before and after improved significantly.Heads up palpebral fissure before the treatment(10.626 ± 1.577) mm down to(9.517±1.235) mm after treatment.The recovery rate of upper eyelid late fall was 26.8%.Treatment before the upper eyelid back an average of 1.849 ±0.797 mm, eyelid closure insufficiency is on average(2.088 ± 1.182) mm, after treatment respectively(0.504±0.504) mm,(0.500±0.501) mm, were significantly improved.Inflammation, irritation and self-conscious symptom improvement, eye movement scoring average(4.317±4.317) before the treatment to(2.228 ± 2.359) after treatment, diplopia, the 82.6%. Corneal disease treatment effective rate was 57.1%. For CAS score before treatment(2.160±1.228) points, measured after treatment scores for(0.832±0.857), decreased obviously.Four patients increased intraocular pressure.No other complications.Conclusion Triamcinolone acetonide peri-orbit injection treatment of TAO, can effectively improve vision, exophthalmos, eye movement, diplopia, eyelid), corneal lesions, relieve infl

关 键 词：曲安奈德 甲状腺相关眼病 眶周注射 

分 类 号：R771.3[医药卫生—眼科]