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目的 探讨甲状腺相关性免疫眼眶病眼外肌病变的手术治疗特点。方法 回顾分析我院自1 993年 1月到 1 999年 1 2月施斜视矫正术的 2 0例甲状腺相关性免疫眼眶病眼外肌病变患者。其中男1 4例 ;女 6例 ;年龄 2 8 0 67 0岁 (平均 5 0 2岁 )。手术方式包括下直肌后退术 (1 2条 ) ,上直肌后退术 (7条 ) ,下直肌缩短术 (4条 ) ,上直肌缩短术 (2条 ) ,上直肌断腱术 (2条 ) ,内直肌后退术(1条 ) ,外直肌缩短术 (1条 )。术后平均随访 1年。结果 术后 9例达到正位 ,复视消失 ;7例术后斜视度小于或等于 5° ,4例有小度数斜视但复视明显改善 ;手术并发症为 :肌肉缝线撕脱 2例 ,过矫3例 ,欠矫 4例 ;轻度眼睑退缩 5例。过矫 3例中 2例是由于术后手术肌肉缝线撕脱所致 ,经手术探查肌肉复位后眼位矫正满意。结论 甲状腺相关性免疫眼眶病眼外肌病变的手术治疗效果满意。
Objective To investigate the surgical treatment of extraocular muscle lesions of thyroid-associated orbital diseases. Methods A retrospective analysis of 20 cases of thyroid-related orbital ocular diseases in our hospital from January 1993 to January 1999 was performed. There were 14 males and 6 females, with a mean age of 28 0 67 years (average 52 years). Surgical procedures included rectus abdominis muscle retraction (12), superior rectus muscle retraction (7), lower rectus muscle shortening (4), superior rectus muscle shortening (2), superior rectus tendon surgery (2), rectus muscle retraction (1), lateral rectus shortening (1). After an average follow-up of 1 year. Results The postoperative 9 cases reached the positive position, diplopia disappeared; 7 cases of postoperative strabismus less than or equal to 5 °, 4 cases had a small degree of strabismus but diplopia significantly improved; operative complications: muscle suture avulsion in 2 cases, Overcorrection in 3 cases, undercorrection in 4 cases; mild eyelid retraction in 5 cases. Overexertion in 3 cases in 2 cases due to surgical suture caused by muscle suture, after surgical exploration of muscle reset eyesight correction satisfactory. Conclusion Thyroid-related immunosorbable orbital ocular lesions of the surgical treatment of satisfactory results.