先天性上斜肌麻痹的手术方式选择  

Surgeries of congenital superior oblique palsy.

作　　者：霍鸣[1] 李娟[1] 靳昆[1] 鸟王国华 

机构地区：[1]三峡大学第一临床医学院宜昌市中心人民医院眼科,湖北宜昌443003

出　　处：《眼外伤职业眼病杂志》2005年第11期827-829,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的观察不同手术方式对先天性上斜肌麻痹的治疗效果.方法对我院收治的52例(59眼)先天性上斜肌麻痹的手术方式和疗效作回顾性分析.结果52例(59眼)中11例(13眼)施行了下斜肌断腱术,23例(26眼)施行了下斜肌后徙术,18例(20眼)施行了下斜肌后徙前转位术.18例(20眼)治愈,23例(28眼)好转,总有效率78.85%(41例).下斜肌断腱术有效率81.82%,下斜肌后徙术有效率78.26%,下斜肌后徙前转位术有效率77.78%.结论上斜≤15△可采用下斜肌断腱术或下斜肌后徙术,下斜肌断腱术与下斜肌后徙术具有同样的矫正效果.上斜16△～25△可采用下斜肌后徙并前转位术,上斜≥25△可采用下斜肌后徙并前转位联合配偶肌(对侧眼下直肌)后徙术.Objective To observe the curative effect of various types of surgery for congenital superior oblique palsy. Methods Tifty- two patients with congenital superior oblique palsy underwent surgical treatment in our hospital were studied retrospectively. All patients were followed up from 6 months to 10 years. Results Among the fifty-two patients, 11 were treated by tenotomy of the inferior oblique muscle for superior oblique palsy. 23 were treated by recession of the inferior oblique muscle and 18 by anterior transposition of the inferior oblique muscle. The surgical effect were divided into three groups which involved comlete cure,improvement and failure. 18 cases achieved a complete cure and 24 cases got an improvement, the total effective rate was about 78.85 %. The effective rate of tenotomy of the inferior oblique muscle was 81.82% ,recession of the inferior oblique muscle was 78.26%, anterior transposition of the inferior oblique muscle was 77.78%. Conclusion Patient with an angle of superior squint in less than 15^△ were treated by the tenotomy of the inferior oblique muscle or recession of the inferior oblique muscle, the corrective effect of sectional tendon surgery for superior oblique palsy equals that for inferior oblique muscle retrocession. Less than 25^△ were treated by the inferior oblique muscle translocation method, exceed 25^△ were treated by combined the inferior oblique muscle translocation method with recession of the inferior rectus muscle （yoke muscles）.

关 键 词：上斜肌麻痹 先天性 手术 疗效 

分 类 号：R779.6[医药卫生—眼科]