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目的探讨应用眼睑缝合术联合球后放射治疗严重甲状腺相关眼病的临床适应证和疗效。方法选择2002年1月～2007年6月于我院眼科就诊的45例暂不能行眼眶减压术的甲状腺相关眼病所致的暴露性角膜炎、角膜溃疡患者,其中19例行暂时性内、外侧眼睑缝合术、26例行暂时性全眼睑缝合术,术后配合球后放射治疗。根据眼部炎性反应的不同程度,口服泼尼松60mg/d,7d后逐渐减量直至停药(其中3例患者因糖尿病血糖控制不佳未使用)。患者术后1～6个月剪开缝合,观察临床疗效。结果术后1～6个月逐渐剪开眼睑缝合后,眼睑闭合完全,角膜炎和角膜溃疡痊愈,视力从术前手动至0.6提高到术后0.1～1.0,手术前、后视力比较差异有统计学意义(P<0.05〉。结论眼睑缝合术配合球后放疗是一种治疗甲状腺相关眼病眼睑闭合不全引起的暴露性角膜炎和角膜溃疡并发症的有效方法。
Objective To investigate the clinical indications and curative effect of applying eyelid suture combined with posterior ball radiation to treat severe thyroid associated ophthalmopathy. Methods From January 2002 to June 2007 in our hospital 45 cases of ophthalmology temporarily can not be treated with orbital decompression of thyroid-associated eye disease caused by keratitis, corneal ulcer patients, of which 19 cases were temporary, Lateral eyelid suture, 26 cases of temporary total eyelid suture, postoperative ball radiation therapy. According to the degree of ocular inflammatory response, prednisone 60mg / d, 7d gradually reduced until the withdrawal (of which 3 patients due to poor blood glucose control not used). Patients 1 ~ 6 months after the open suture, observe the clinical efficacy. Results 1 ~ 6 months after the operation gradually cut off the eyelid suture, the eyelid closed completely, keratitis and corneal ulcer healed, visual acuity from 0.6 before surgery to 0.6 to 1.0 after surgery, before and after surgery, visual acuity difference statistics (P0.05) .Conclusion Eyelid suture combined with posterior pelvic radiotherapy is an effective method to treat the complications of keratitis and corneal ulcer caused by the eyelid insufficiency of thyroid-associated ophthalmopathy.