上斜肌腱缝线延长术  

A suture spacer in weaken surgery of superior oblique tendon

作　　者：冯雪亮[1] 张树梅[1] 李俊红[1] 

机构地区：[1]山西省眼科医院斜视与小儿眼科,太原030002

出　　处：《中国实用眼科杂志》2005年第10期1134-1136,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的为了避免上斜肌断腱术引起的上斜肌麻痹,手术不能定量,术后发生过矫,及因断端丢失造成再次手术困难等缺点,行改良的上斜肌腱缝线延长术,即能减弱上斜肌的作用,又能达到部分、定量及可逆的上斜肌减弱效果。方法颞上象限打开球结膜及Tenon氏囊,暴露鼻上象限术野,暴露上斜肌肌腱,用小斜视钩沿上直肌腱走行方向,向后轻轻钩起白色的上斜肌肌腱,分离肌鞘,用两根非吸收线,分别在肌腱上缝两根预置缝线,相距约4mm,在两根缝线之间剪断肌腱,根据术前上斜肌亢进程度,决定两断端间缝线延长的距离。结果20例A型斜视的上斜肌功能亢进均取得明显改善,无1例过矫。结论上斜肌腱缝线延长术,手术效果较肯定,可预防过矫,操作较硅胶带延长术容易,较可调缝线的上斜肌腱延长术更便利,并发症少。Objective To avoid the side effect of superior oblique tenotomy, such as sencondary superior oblique palsy, overcorrection. The study described a modified procedure to make the surgery much more easy to be controlled, be reversible and be qualtified. Methods Exposuring superior oblique tendon as routine, 2 nonabsorbable sutures were preplaced between 4mm, cutting the tendon between two sutures. According to the grade of superior oblique overaction the suture spacer will be 6mm （grade 2 ＋ ）, 8mm （ 3 ＋ ） and 10mm （4 ＋ ）. Results 22 cases suprior oblique overaction got good results. Conclusions A suture spacer for superior oblique weaking is easy to performed and decreased the complications due to tenotomy.

关 键 词：上斜肌腱缝线延长术 上斜肌麻痹 硅胶带 斜视 牵拉试验 

分 类 号：R777.4[医药卫生—眼科] R779.6[医药卫生—临床医学]