甲状腺眼病的两壁与三壁轨道减压:系统性审查和元分析
Haissan Iftikhar1, Muhammad Hammad Deewani2, Syed Akbar Abbas2
1Department of Rhinology and Anterior Skull Base Surgery, University Hospital Birmingham, Birmingham, England.
JPMA. The Journal of the Pakistan Medical Association
|June 11, 2025
概括
与甲状腺眼病的双壁减压相比,三壁轨道减压显示出质的显著降低. 然而,证据有限,无法最终确定新发性双眼盲的优越性.
科学领域:
- 眼科医生 眼科 眼科
- 手术创新 在外科创新.
- 基于证据的医学基于证据的医学.
背景情况:
- 甲状腺眼病 (TED) 往往需要手术轨道减压来管理proptosis和diplopia.
- 采用双壁 (中部和下部) 和三壁解压技术,结果各不相同.
- 这些减压方法的比较有效性仍然是临床兴趣的领域.
研究的目的:
- 为了评估三壁轨道解压与两壁解压的有效性.
- 为了比较对减少形 (凸起的眼睛) 和新发性双眼视 (双视) 的发生率的影响.
主要方法:
- 1948年至2019年出版的研究的系统审查和定性评估.
- 在包括PubMed,Web of Science和Cochrane Library在内的主要数据库中进行文献搜索.
- 结尾镜双壁 (中/下) 解压与三壁解压技术的比较.
主要成果:
- 只有两项研究符合资格标准,涉及72名患者 (37名双壁,35名三壁).
- 三面壁解压显示出一种统计学上显著的降低了proptosis (p=0.0003).
- 观察到与双壁解压的新发性双眼视病例减少的趋势,但不具有统计学意义 (p=0.39).
结论:
- 有限的证据表明,三壁轨道解压对于TED来说优于两壁解压.
- 需要进一步进行高质量的研究,以澄清治疗TED相关眼部并发症的最佳手术方法.
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