眶周注射曲安奈德联合球后放疗治疗甲状腺相关眼病

Observation of curative effect of triamcinolone acetomide periocular injection combined with retro-orbital radiation on TAO

目的探讨眶周注射曲安奈德联合球后放疗治疗甲状腺相关眼病的疗效。方法本院治疗甲状腺相关性眼病患者82例132眼,随机分为联合治疗组40例和对照组42例:联合治疗组给予眶周注射曲安奈德10 mg联合球后放疗;对照组仅给予眶周注射曲安奈德20 mg。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,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),联合治疗组眼球突出度、睑裂宽度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80%,治疗组改善率为70%。结论眶周注射曲安奈德联合球后放疗是治疗甲状腺相关眼病的一种有效方法,治疗效果优于单用眶周注射曲安奈德。

Objective To explore the curative effect of triamcinolone acetomide（TA） periocular injection combined with retro-orbital radiation on TAO.Methods 82 cases（132 eyes） with TAO were randomly selected.According to different methods of therapy,the patients were randomly divided into two groups： combined therapy group with 10mg TA periocular injection and retroorbital radiation and control group with 20mg TA w only.The degree of exophalmus and width of palpebral fissure were measured and their symptoms and ocular signs were observed before and after treatment.Extrocular muscles and peiorbital tissue were inspected by CT.Results In combined therapy group,there was a significant difference in the degree of exophthalmus and width of palpebral before and after treatment（P0.05）.In control group,there was a obvious difference in the degree of exophthalmus before and after treatment（P0.05）.The degree of exophthalmus and width of palpebral fissure in combined therapy group decreased more significantly than those in control group（P0.05）.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 80% in combined therapy group which was 70% in control group.Conclusion Combined application of periocular injection of TA and retro-orbital radiation is effective for the treatment of TAO.