Graves病临床治疗及分析

Clinical therapy and analysis for thyroid associated ophthalmopathy

目的分析Graves病的临床特点和治疗方法.方法对近5年来哈尔滨医科大学附属第二医院收治的37例Graves病患者进行回顾分析.根据患病严重程度和活动与否选择治疗方法,单纯药物治疗23例,手术联合药物治疗14例.随访1个月～5年(平均1年).结果23例单纯用药组患者中明显有效的17例,占73.9%.手术患者中,4例突眼患者进行眶减压手术治疗,3例两壁减压平均减少眼球突出度4.2 mm,1例三壁减压术后减少眼球突出度7.5 mm.9例眼肌病患者中,6例术后双眼达到正位,复视消失;2例斜视度数明显减小,复视明显减轻;1例过矫,重新调整固定后达到正位.3例眼睑退缩患者矫正良好,凝视症消失,眼部外观改善.结论严重的活动期患者应用糖皮质激素全身治疗效果较好,静止期患者手术联合药物治疗效果满意.

Objective To investigate the method and characteristics of clinical therapy of Graves disease. Methods 37 cases were included which were diagnosed as Graves disease during past 5 years in the Second Affiliated Hospital of Harbin Medical University. We chose medication or surgical treatment by severe and active degree. There were 23 medicine-controlled cases and 14 surgical treatment cases. Results 17 medicine-controlled cases got good curative-effect, and almost all surgical treatment patients became normal ocular alignment after operation. Conclusions To severe active Graves disease patients, simply using glucocorticoid is a effective method. But to resting stage cases, surgical treatment combined drug therapy will get good curative-effect.