改良式提上睑肌延长术对中重度TAO上睑退缩的临床疗效评价  

Clinical evaluation of modified levator lengthening on moderate to severe thyroid-associated ophthalmopathy for upper eyelid retraction

作　　者：张雪 闫欢欢 艾华[1] 李春花[1] ZHANG Xue;YAN Huanhuan;AI Hua(Ophthalmology Department,Xi'an Fourth Hospital,Xi'an 710004,China)

机构地区：[1]西安市第四医院眼科,西安710004

出　　处：《中国中医眼科杂志》2020年第8期567-570,共4页China Journal of Chinese Ophthalmology

摘　　要：目的评估改良式提上睑肌延长术对中重度甲状腺相关眼病(TAO)上睑退缩患者容貌外观、视功能及生活质量的影响。方法选取100例中重度静止期TAO上睑退缩患者入组,按照随机数字表法分为改良组和对照组,各50例。对照组给予提上睑肌中央腱膜切断术治疗,改良组给予改良式提上睑肌延长术治疗,比较两组患者容貌外观、治疗效果及生活质量的变化。结果 (1)术后容貌变化:改良组与对照组比较,患者睑裂高度(t=9.113,P=0.000)、上睑缘角膜映光距离(t=9.749,P=0.000)及眼睑闭合时露白值(t=39.131,P=0.000),改良组各指标值改善程度均优于对照组,有统计学意义。(2)术后症状改善率:改良组为98.00%,对照组为86.00%,改良组高于对照组(x^2=4.891,P=0.027),有统计学意义。(3)术后生活质量:改良组与对照组比较,患者视功能(t=8.243,P=0.000)、社会心理评分(t=8.413,P=0.000),改良组评分均高于对照组,均有统计学意义。结论改良式提上睑肌延长术可改善中重度TAO上睑退缩患者容貌外观,恢复视功能,提高患者生活质量,值得推广和应用。OBJECTIVE To evaluate the effect of modified levator lengthening on the appearance, visual function and quality of life in the patients with moderate to severe thyroid-associated ophthalmopathy(TAO) in upper eyelid retraction. METHODS A case-control study was conducted. One hundred patients with upper eyelid retraction in moderate to severe stationary thyroid-associated ophthalmopathy were selected and divided into the improved group and the control group, according to random number table method, 50 cases in each group. The control group was treated with central aponeurotomy of levator palpebrae muscle, while the improved group was treated with modified levator lengthening. The changes of appearance, treatment effect and quality of life were compared between the two groups. RESULTS(1) Facial appearance changes after operation : Compared with the control group, the height of blepharoplasty(t= 9.113,P=0.000), the upper eyelid limbus corneal reflection distance(t=9.749, P=0.000) and the exposure value of eyelid closure(t=39.131, P=0.000) in the improved group were better than that in the control group, with statistical significance.(2) The improvement rate of postoperative symptoms: The improved group was 98.00% and the control group was 86.00%. The improved group was higher than the control group(x^2 =4.891,P=0.027).(3) The postoperative quality of life: Compared with the control group,the visual function(t= 8.243, P= 0.000) and social psychological scores(t=8.413, P=0.000) in the improved group were higher than that in the control group, with statistical significance. CONCLUSIONS Modified levator lengthening could improve the appearance, restore visual function and improve the quality of life of patients with moderate to severe thyroid-associated ophthalmopathy for upper eyelid retraction, which was worthy of promotion and application.

关 键 词：提上睑肌延长术 甲状腺相关眼病 上睑退缩 视功能 

分 类 号：R777.5[医药卫生—眼科]