67例Duane眼球后退综合征的临床分析  

A clinical analysis of sixty-seven cases with Duane′s retraction syndrome

作　　者：陈霞[1] 赵堪兴[1] 宋坤英[1] 郭新[1] 马惠芝[1] 杜翠琴[1] 朱丽娜[1] 

机构地区：[1]天津市眼科医院,300040

出　　处：《中华眼科杂志》2005年第9期812-816,共5页Chinese Journal of Ophthalmology

摘　　要：目的探讨Duane眼球后退综合征(DRS)的临床特征以及手术治疗的方法和效果。方法对67例因DRS行手术治疗的患者资料进行回顾性总结和分析,观察项目包括患者的性别和年龄、DRS类型和临床表现、手术治疗方式和效果。结果单眼受累63例,双眼受累4例。Ⅰ型内斜视35例,外斜视12例;Ⅱ型外斜视8例;Ⅲ型内斜视1例,外斜视11例。37例患者合并内转眼急速上转和(或)下转现象,其中31例为外斜视者。行单眼内直肌和(或)外直肌后徙术或双眼内直肌后徙术可改善代偿头位、眼球后退及睑裂变小体征,术后斜视度数≤10△者60例(89.6%)。行患眼内直肌和(或)外直肌后徙术,可使内转眼急速上转和下转现象得到明显改善。结论不同类型DRS的临床表现不同,内转眼上、下转现象多见于DRS外斜视者。减弱内、外直肌功能可改善DRS的临床表现;外直肌后徙术是改善内转眼急速上、下转现象的主要方法;内、外直肌同时后徙术适用于眼球后退和急速上、下转现象严重者;减弱一侧直肌功能后,眼球向对侧转动的受限程度得到改善。Objective To analyze the clinical manifestations and the methods and effects of surgical management on Duane＇ s Retraction Syndrome （ DRS ） . Methods 67 cases with DRS were summarized retrospectively. The data were recorded and analysed, including sex, age, type, clinical features, surgical methods and the results. Results 63 cases had only monocular involvement. The number of Type Ⅰ DRS was 47 cases （35 cases with esotropia, 12 cases with exotropia）. 8 cases were Type Ⅱ DRS with exotropia and 12 cases were Type Ⅲ DRS （11 of them with exotropia）. In 37 cases with upshoot and/or downshoot phenomenon, 31 of them were associated with exotropia. Ipsilateral medial rectus or lateral rectus recession, or bilateral medial rectus recession, improved the head compensation position, narrow palpebral fissure and globe retraction, with improvement or elimination of the deviation. After the operation, 60 cases （900/0） showed horizontal tropia less than 10 prism diopters. Upshoot and/or downshoot were improved in all of the 37 cases after recessing medial or/and lateral reeti, or simultaneously weakening of the inferior oblique muscle. Conclusion Weakening medial and/or lateral recti can improve the clinical manifestations of DRS. Upshoot and downshoot are more common in eyes with exotropia. Lateral rectus recession is the main treatment method for relieving upshoot and downshoot in DRS with exotropia. We infer that the upshoot and downshoot phenomenon mainly related to the “bridle” effect. Recession of both horizontal recti can improve the serious clinical manifestations. （Chin J Ophthalmol , 2005,41：812-816）

关 键 词：DUANE眼球后退综合征 临床分析 手术治疗 斜视度数 动眼肌 

分 类 号：R777.41[医药卫生—眼科]