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甲状腺乳头状癌甲状腺切除术后视网膜分支动脉阻塞:一例报告

Branch retinal artery occlusion following thyroidectomy for papillary carcinoma of the thyroid: report of a case.

作者信息

Kihara S, Ohtuka H, Ikenaga T, Kawano I, Ogawa M

机构信息

Department of Nursing, Faculty of Education, Kumamoto University Medical School, Japan.

出版信息

Surg Today. 1993;23(8):750-4. doi: 10.1007/BF00311718.

Abstract

A rare case of branch retinal artery occlusion (BRAO) following a subtotal thyroidectomy for thyroid cancer in a 58-year-old woman is reported herein. Five days after her thyroidectomy, the patient complained of having had a reduction in visual acuity and visual field loss of the superior nasal side in her right eye since the operation. BRAO was diagnosed following the discovery by funduscopy of inferotemporal branch artery occlusion with retinal edema, hemorrhage, and periarterial sheathing in the right eye. Despite immediately puncturing the anterior camera and massaging the eyeball while administering intravenous anticoagulant therapy, the visual field disturbance remained unchanged. The most common causative factor of postoperative sudden BRAO is reported to be emboli. However, in our case, the most likely cause was the stretching and pressure exerted on the carotid artery with consequent atheromatous plaque formation at the time of thyroidectomy.

摘要

本文报道了一例58岁女性甲状腺癌患者在甲状腺次全切除术后发生视网膜分支动脉阻塞(BRAO)的罕见病例。甲状腺切除术后五天,患者主诉自手术以来右眼视力下降,鼻上侧视野缺损。眼底镜检查发现右眼颞下分支动脉阻塞伴视网膜水肿、出血和动脉周围鞘膜,诊断为BRAO。尽管立即穿刺前房并按摩眼球,同时给予静脉抗凝治疗,但视野障碍仍未改变。据报道,术后突发BRAO最常见的致病因素是栓子。然而,在我们的病例中,最可能的原因是甲状腺切除术时对颈动脉的牵拉和压迫,继而形成动脉粥样硬化斑块。

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