球后注射曲安奈德联合眶部放射治疗中度甲状腺相关性眼病疗效观察

目的:探讨球后注射曲安奈德联合眶部放射治疗中度甲状腺相关性眼病的疗效。方法:本院治疗的中度甲状腺相关性眼病患者32例60眼,随机分为联合治疗组和对照组:联合治疗组给予球后注射曲安奈德10mg联合眶部放射;对照组给予球后注射曲安奈德10mg。分别测量两组患者治疗前后的眼球突出度及睑裂宽度,观察眼球运动及自觉症状,根据Donaldson等的分级评分系统评估治疗效果,并行眼眶CT检查眼外肌和眶周组织水肿改善情况。结果:联合治疗组治疗前后眼球突出度、睑裂宽度及眼病分值差异有显著性(P<0.05),对照组治疗前后眼球突出度差异有显著性(P<0.05),但睑裂宽度及眼病分值差异无显著性(P>0.05),联合治疗组眼球突出度、睑裂宽度及眼病分值的降低值较对照组明显,两者差异有显著性(P<0.05)。两组患者复视及眼球运动都有改善,CT检查眼外肌和眶周组织水肿都有所改善,但联合治疗组改善率为81%,治疗组改善率为71%。结论:球后注射曲安奈德联合眶部放射是治疗中度甲状腺相关性眼病的一种有效方法,治疗效果优于单用球后注射曲安奈德。

Observation of curative effect of Triamcinolone acetomide retrobular injection combined with orbital radiation on TAO

AIM: To explore the curative effect of Triamcinolone acetomide (TA) retrobular injection combined with orbital radiation on moderate thyroid-associated ophthalmo-pathy (TAO). ·METHODS: Thirty-two cases (60 eyes) with TAO admitted in our department were randomly selected. According to different methods of therapy, all were randomly divided into two groups: combined therapy group and control group: for combined therapy group, 10mg TA retrobular injection and orbital radiation were executed; for control group, 10mg TA was injected retrobularly only. Then the degree of exophthalmus and width of palpebral fissure in two groups were measured and their symptoms and ocular signs were observed before and after treatment. The therapeutic effect was evaluated based on Donaldson’s grade scoring system. Extraocular muscles and periorbital tissues were inspected by CT. ·RESULTS: In combined therapy group, there was a significant difference in the degree of exophthalmus and width of palpebral and ophthalmocace values before and after treatment (P<0.05). In control group, there was a significant difference in the degree of exophthalmus before and after treatment (P<0.05), but distinct difference in width of palpebral and ophthalmocace values was not found. In addition, the degree of exophthalmus and width of palpebral fissure and ophthalmocace valves in combined therapy group decreased more prominently than those in control group (P<0.05). Diplopia and ocular movement were improved in both groups. CT test also confirmed the improvement of extraocular muscles and periorbital tissues edema, but the improvement rate was 81% in combined therapy group which was 71% in control group. ·CONCLUSION: Combined application of retrobular injection of TA and orbital radiation was an effective approach for the treatment of moderate TAO. Its therapeutic efficacy was better than administration of TA alone.