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作者介绍在Graves病中作眶减压术。方法如下: 术前全面的眼部检查,不仅对确定诊断及手术指征,而且对以后估价结果也是非常必要的。内科会诊确定病人的甲状腺情况后手术需全麻并插管,因血可聚集于咽部,用蘸有5%可卡因加1∶100,000肾上腺素的棉片填塞上鼻腔,可减少鼻粘膜和筛窦出血。下睑皮下注射1 ml利多卡因+1∶100,000肾上腺素以减少出血。睑缘置-4-0丝线做牵引用。按照睑成型术切开皮肤。将眼轮匝肌与睑板和眶隔分离,并剪断眼轮匝肌全层至眶隔平面。用剪或手指钝剥离,将眼轮匝肌和眶隔之间的间隙向下分离至下睑缘。此时常有相当量的眶脂肪脱出。脱出的脂肪用止血钳夹住后切除。残端烧灼止血。切除脂肪可增进手术其余部分的暴露、
The authors describe orbital decompression in Graves disease. Methods are as follows: a comprehensive preoperative eye examination, not only to determine the diagnosis and surgical indications, but also for the subsequent evaluation of the results is also very necessary. Medical consultation to determine the patient’s condition after thyroidectomy anesthesia and intubation, due to blood can be gathered in the pharynx, dipped in 5% cocaine plus 1: 100,000 epinephrine padding on the nasal cavity, can reduce the nasal mucosa and ethmoid Bleeding. Subcutaneous injection of 1 ml lidocaine + 1: 100,000 epinephrine to reduce bleeding. Eyelid set -4-0 silk used for traction purposes. Cut the skin according to blepharoplasty. Orbicularis muscle and tarsus and orbital septum separated, and cut orbicularis oris entire layer to the orbital plane. Blunt dissection with scissors or fingers, the orbicularis muscle and orbital septum gap down to the lower eyelid. At this point often a considerable amount of orbital fat prolapse. Prolapse of fat with hemostatic forceps after removal. Stump cautery to stop bleeding. Removal of fat can improve the rest of the surgery,