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目的对比两种术式矫正甲状腺相关眼病上睑退缩的临床疗效。方法将22例(32只眼)甲状腺相关眼病上睑退缩患者,随机分为A、B两组。A组11例18只眼采用上睑提肌中央腱膜切断术矫正;B组11例14只眼采用上睑提肌和Muller肌延长术矫正。术后随访6个月,评价其临床疗效。结果所有患者术后自觉症状均明显减轻或消失,A组及B组各自术前与术后疗效相比,均有统计学意义(P<0.01),组间比较无统计学意义(P>0.05)。术后6个月A组有4例6眼,B组有1例1眼上睑回退,经卡方检验,回退率组间比较有统计学意义(P<0.05)。两组均无一只眼过矫。结论两种术式均可有效矫正静止期甲状腺相关眼病的上睑退缩,但上睑提肌和Muller肌延长术回退率低。
Objective To compare the clinical effects of two surgical procedures to correct the upper eyelid retraction in thyroid-associated ophthalmopathy. Methods Twenty-two patients (32 eyes) with upper eyelid degeneration associated with thyroid-associated ophthalmopathy were randomly divided into A and B groups. Eleven patients in group A were treated with levator muscular central aponeurosis and 18 patients in group B. Eleven patients in group B were corrected with levator levator muscle and Muller muscle lengthening. The patients were followed up for 6 months to evaluate their clinical efficacy. Results All patients had significant reduction or disappearance of symptoms after operation. The preoperative and postoperative efficacy of group A and group B were statistically significant (P <0.01), and there was no significant difference between the two groups (P> 0.05 ). Six months after operation, there were 4 cases in group A, 6 cases in group B, and 1 case in group B, with a regression of upper eyelid. There was significant difference between the two groups (P <0.05). No one eye overcorrection in both groups. Conclusion Both procedures can effectively correct the retraction of upper eyelid in patients with quiescent thyroid-associated ophthalmopathy, but the lengthening of levator levator muscle and Muller’s muscle is low.