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頁籤選單縮合
題名 | Change of Proptosis after Extraocular Muscle Surgery in Graves' Ophthalmopathy=葛瑞芙氏眼病變施行眼外肌手術後其突眼程度的改變 |
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作者姓名(中文) | 廖述朗; 高啟祥; 侯平康; | 書刊名 | 慈濟醫學 |
卷期 | 8:2 1996.06[民85.06] |
頁次 | 頁91-96 |
分類號 | 416.7 |
關鍵詞 | 葛瑞芙氏眼病變; 突眼; 眼窩減壓術; 眼肌放鬆術; Graves' ophthalmopathy; Proptosis; Orbital decompression; Muscle recession; |
語文 | 英文(English) |
中文摘要 | 葛瑞芙氏眼病變是一種自體發炎反應造成的眼外肌發炎肥大,而導致臨 床上幾個重要表徵如突眼、複視、眼瞼攣縮及視神經病變。一般治療採用階段性 手術,先施行眼窩減壓術,按著是眼外肌手術,最後才是眼皮手術。本研究想探 討經過眼外肌手術,放掉眼外肌後,是否會影響突眼程度,而減少先前眼窩減壓 術治療突眼的效果。 20個有複硯之葛瑞芙氏眼變病人經眼外肌手術治療,我們記錄其術前、術後六個 月突眼程度 (用Henrel exophthalmometer量)。有14個病人單側眼開刀,其中只有2 個病人6個月後其開刀眼及未開刀眼突眼改變程度相差大於2mm。統計上並無顯 著意義(paired t test)。除此之外,有6個病人兩眼都接受眼外肌手術,只有一眼突 眼改變程度大於2mm。由以上結果顯示,眼外肌手術後,其突眼程度並無顯著改 變,目前用階段性手術來治療葛瑞芙氏眼病變依然是有用的。(慈濟醫單 1996;8:91-96) |
英文摘要 | Graves' ophthalmopathy is an autoimmune inflammatory process affecting the extraocular muscles.The enlargement of these muscles is responsible for most of the important manifestations of Graves'ophthalmopathy including proptosis, diplopia, and optic neuropathy. The conventional order of stagedtreatment is 1) orbital decompression, 2) muscle surgery and 3) eyelid surgery. This study addressedwhether the release of the extraocular muscles by surgery affects the degree of proptosis and hencedampens the retroplacement effect of orbital decompression. Twenty cases of Graves' ophthalmopathy with diplopia were corrected by muscle recession with anadjustable suture procedure. The degree of proptosis as measured by a Hertel exophthalmometer wasrecorded both preoperatively and six months postoperatively. Fourteen patients were operated on unilaterally, but only two of them experienced a difference ofproptotic change between both eyes of more than 2 mm six months postoperatively. There were nostatistically significant changes petween the surgically-treated eyes and the fellow eyes. (paired t test)Furthermore, in the six patients who received bilateral muscle recession, only one eye showed morethan a 2 mm increase of proptosis six months postoperatively. There is no significant change in the degree of proptosis following surgical recession of theextraocular muscles. Therefore, the present concept of staged operation seem to be valid.(Tzu ChiMedJ1996;8:91-96) |
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