中国内镜杂志2012，Vol.18Issue(8)：821-825,5.
内镜下经筛肌锥内脂肪减压矫治Graves眼病性突眼
Endoscopic transethmoid intraconal fat decompression for proptosis reduction in thyroid associated orbitopathy
摘要
Abstract
[Objective] To study the suitability of an endoscopic transethmoid intraconal fat decompression (ETIFD) for proptosis reduction in patients with Graves' orbitopathy (GO). [Methods] Based on the history, complete ophthalmic examinations, and computer tomography or MRI scans of the orbit, all patients were diagnosed in the inactive phase of lipovarant GO and underwent the ETIFD for proptosis reduction from October 2006 to December 2011. The patients were followed up periodically at least for 6 months after surgery. At the 6-month review, outcomes including proptosis reduction, incidence of diplopia and other complications were reviewed and analyzed. [Results] Twenty-four patients (44 orbits) with complete clinic data were analyzed in this study. Preoperative, the exophthalmometer value (EV) of the affected eyes ranged from 17 to 23 mm [mean, (19.98±1.80) mm]; At the 6 month review, the EV improved to (12.93±0.76) mm (range, 12-14) mm. A postoperative symmetry to within 2 mm of the both eyes was achieved in all patients (100%, 24/24), with a mean improvement of (7.05±1.40) mm (range, 4-10) mm (t=33.455, P <0.001). Ten of 24 patients presented horizontal diplopia within 30 degree visual field of the lateral gaze, in which 8 patients disappeared within one month after surgery. At the 6 month review, except that 2 patients complained diplopia' and corrected with triangular lens, no patients presented any complications. [Conclusion] ETIFD is an effective treatment with minimal morbidity for proptosis reduction in lipovarant GO.关键词
Graves眼病/脂肪减压术/内镜技术/眼球突出/并发症Key words
thyroid-associated ophthalmopathy/ orbital fat decompression/ endoscopic technique/ exophthalmos/ diplopia分类
医药卫生引用本文复制引用
姜方正,余波,卞杨,李晓勇,涂云海,陈犇,施节亮,吴文灿..内镜下经筛肌锥内脂肪减压矫治Graves眼病性突眼[J].中国内镜杂志,2012,18(8):821-825,5.基金项目
浙江省卫生厅社会发展计划基金资助(No.2007A144) （No.2007A144）
