Exophthalmos yog lo lus siv los hais txog qhov protrusion ntawm ib lossis ob lub qhov muag sab nraum lub orbit. Peb kuj hais txog qhov muag lossis qhov muag pom (s).

Qhov muag pom loj dua, "qhib" ntau dua, uas tuaj yeem cuam tshuam nrog qhov kaw ntawm daim tawv muag ntxiv rau qhov ua rau tsis xis nyob. Exophthalmos tsis yog vim qhov loj ntawm qhov muag, tab sis qhov nce ntawm qhov loj ntawm cov leeg lossis cov qauv hauv lub qhov muag (tej zaum muaj pob hauv qhov muag). orbit). Lub qhov muag bulging kuj yuav deviated thiab zoo li yuav saib nyob rau hauv ib qho kev taw qhia txawv ntawm lub qhov muag ib txwm. Feem ntau, txawm li cas los xij, ob lub qhov muag raug cuam tshuam.

Exophthalmos tuaj yeem raug cais lossis cuam tshuam nrog lwm cov tsos mob, xws li txo qhov muag pom kev, pom ob lub qhov muag (diplopia), mob, liab liab, thiab lwm yam.

Exophthalmos tuaj yeem ua rau tsis meej pem thiab tsis pom kev, tab sis nws tsis yog ib txwm pom tseeb tam sim: nws kuj tuaj yeem pom thaum lub sijhawm kuaj qhov muag.

Muaj ntau yam ua rau exophthalmos: endocrine, qog, inflammatory, traumatic thiab vascular.

Tus kws kho mob ophthalmologist yuav tshuaj xyuas qhov tsis sib haum xeeb lossis ob sab ntawm qhov teeb meem, nws txoj kev kawm (ceev los yog tsis), txawm tias lub qhov muag yog deflected los yog tsis ("axillary" los yog tsis-axillary cim), thiab kev xav ntawm "mulse" los yog ib tug pulsation. hauv qhov muag (pulsatile cim).

Feem ntau, qhov pib tshwm sim ntawm exophthalmos zoo li kev raug mob lossis kab mob inflammatory. Thaum nws pib maj mam, nws yog qhov tshwm sim los ntawm endocrine lossis qog pathology.

Nov yog cov laj thawj feem ntau:

• Graves' kab mob: qhov no yog kab mob ntawm cov thyroid caj pas (hyperthyroidism) feem ntau ntawm autoimmune keeb kwm. Nws indirectly ua rau mob ntawm cov ntaub so ntswg ntawm lub qhov muag, uas o thiab ua rau lub qhov muag protrude. Lwm cov thyroid kab mob tuaj yeem koom nrog (peb hais txog dysthyroid orbitopathy feem ntau: hyperthyroidism hauv 80% ntawm cov neeg mob, hypothyroidism txog li 10%). Feem ntau, exophthalmos yog ob sab.
• carotid-cavernous fistula: qhov no yog qhov ua rau nquag pom thaum lub exophthalmos yog unilateral thiab pulsatile. Nws yog ib qho kev sib txuas lus txawv txav ntawm sab hauv carotid thiab cavernous sinus (venous tsim nyob rau hauv lub hauv paus ntawm pob txha taub hau), feem ntau yog vim raug mob. Nws yog kev kho mob xwm txheej ceev, txawm tias muaj kev phom sij rau lub neej.
• Traumatic exophthalmos: lawv tshwm sim tom qab poob siab (hematoma, tawg ntawm lub orbit, thiab lwm yam) los yog lub taub hau raug mob.
• Kab mob exophthalmos: cov no feem ntau yog qhov tshwm sim ntawm ethmoiditis, uas yog hais txog kab mob ethmoid, pob txha nyob nruab nrab ntawm ob lub qhov muag. Nws feem ntau cuam tshuam rau menyuam yaus thiab cov tub ntxhais hluas.
• Inflammatory exophthalmos: lawv cov laj thawj tsis yog ib txwm paub, tab sis lawv tuaj yeem cuam tshuam nrog qee yam kab mob xws li sarcoidosis, periarteritis nodosa, Wegener's kab mob, inflammatory vasculitis, thiab lwm yam. Lawv tuaj yeem txuas rau lub orbit abscess, orbital mycosis, cellulitis, thiab lwm yam. .
• Cov qog exophthalmos: lawv yog vim muaj cov qog loj hauv lub qhov muag. Ntau hom qog tuaj yeem cuam tshuam rau thaj chaw no. Nws tuaj yeem ua metastases los ntawm lwm qhov chaw.

Ntxiv nrog rau qhov tsis pom kev ntawm exophthalmos, nws tuaj yeem cuam tshuam tsis pom kev, nrog rau qhov mob, teeb meem uas ua rau pom kev puas tsuaj… Nws yog ib qho tseem ceeb uas yuav tau sab laj nrog koj tus kws kho mob sai sai.

Qhov no muaj ntau yam cuab yeej los ntsuas qhov hnyav ntawm exophthalmos. Feem ntau, nws yuav sau tshuaj ntsuam xyuas (CT scan, MRI) los tsim kev kuaj mob.

Kev kho mob rau exophthalmos nyob ntawm qhov ua rau. Nws yog kev kho mob lossis phais.

Nyob rau hauv cov xwm txheej ntawm cov thyroid kab mob, uas yog feem ntau tshwm sim, noj tshuaj antithyroid ntau lub hlis feem ntau pab kho cov thyroid hormones li qub. Kev phais tshem tawm cov thyroid thiab noj cov tshuaj radioactive iodine kuj tuaj yeem pom zoo, nyob ntawm qhov xwm txheej.

Exophthalmos tsis yog ib txwm txhim kho nrog kev kho mob: nws yog qee zaum txawm tias exacerbated los ntawm nws. Kev noj tshuaj corticosteroids tuaj yeem pab tau, thiab qee zaum kev phais yuav raug qhia, tom qab cov tshuaj hormones rov qab los.

Hauv lwm qhov xwm txheej ntawm exophthalmos, nyob ntawm qhov ua rau, ntau txoj kev daws teeb meem yuav raug txiav txim siab. Cov txiaj ntsig yog nyob ntawm tus mob thiab cov kab mob hauv qab.