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目的:探讨根据眼球突出度分别采取二壁或三壁眶减压治疗Graves眼病临床疗效。方法:眼球突出度<27 mm采用经鼻内窥镜二壁减压(其中7只眼二壁减压效果欠佳,后经眶外壁减压症状改善);>27 mm采用三壁减压。结果:眼球突出度<27 mm采用二壁减压术眼球平均回缩4 mm,眼球突出度>27 mm采用三壁减压眼球平均回缩7 mm;角膜病变均恢复;39只眼视力下降者,30只眼提高,8只眼视力没有改变,1只眼视力下降;眼球活动度及外观均改善。结论:开眶减压是治疗Graves眼病的有效方法,但应根据眼球突出度进行二壁或三壁减压。
Objective: To investigate the clinical efficacy of two-wall or three-wall orbital decompression in the treatment of Graves ophthalmopathy according to the degree of eyeball protrusion. Methods: Nasal endoscopic wall decompression was used in less than 27 mm of nasal endoscopy (seven of them had poor decompression effect on the second wall and ameliorated by decompression of orbital wall), and three-wall decompression of> 27 mm. Results: The degree of eyeball protrusion was 27 mm. The mean reduction of eyeball was 4 mm and the protrusion of eyeball was> 27 mm with three-wall decompression. The average retraction of eyeball with three-wall decompression was 7 mm. The corneal lesions were recovered. , 30 eyes improved, 8 eyes no change in visual acuity, 1 eye visual acuity decreased; eyeball activity and appearance were improved. Conclusions: Operative orbital decompression is an effective method for the treatment of Graves ophthalmopathy. However, decompression of two or three walls should be performed according to the degree of exophthalmos.