改良眼外肌定量调整术治疗儿童斜视  

Modified technique of adjustable suture in children strabismus

作　　者：吴倩[1] 于刚[1] 李子江[1] 漆雅[1] 张诚玥[1] 

机构地区：[1]首都医科大学附属北京儿童医院眼科,北京市100045

出　　处：《眼科新进展》2008年第4期290-291,294,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨儿童改良式眼外肌定量调整缝线术治疗斜视的临床效果。方法采用改良式眼外肌定量调整术,对275例1.3～14岁斜视患儿行斜视矫正。球结膜作PARK切口,强生6-0可吸收缝线作肌肉调整缝合线,剪断肌肉后,将调整缝线呈八字于肌肉附着点下穿出,再将缝线穿出球结膜,以5-0丝线在相应部位扎活动结,以双极射频镊关闭结膜伤口。结果275例患者术后第1天均可正常睁开双眼,正常注视玩耍或配合检查,其中有87例患儿于术后第1天或第2天在表面麻醉下分别作了不同程度的调整,调整率31.6%,其中过矫57例,欠矫30例,所有患儿均可正常接受术后调整的操作,调整后眼位基本满意。结论该术式术后患儿反应轻,术后瘢痕小;患儿基本能接受术后表面麻醉下调整,可作为儿童斜视手术首选术式。Objective To evaluate the improvement of a modified technique of adjustable suture in children strabismus. Methods Orthopia operations were performed on 275 patients of strabflismus aged from 15 months to 14 years with modified technique of adjustable suture. The technique of eonjunctival incision adjustable suture and closure of incision were improved. Using PARK incision of conjunctiva,the 6-0 absorbable suture was used as adjustable suture. After the muscle was disinserted, the sutures were placed through the insertion plane to emerge near to one another. Then the sutures were also brottght out throttgh bulbar conjunctiva. The conjunctiva flaps were closed with nipper of twin electrode. Results Two hundreds and seventy-five consecutive children were all able to open their eyes to fixation or examination within one day after surgery. Eighty-seven of 275 patients underwent an adjustment in surface anesthesia in one day to two days after surgery. The rate of adjustment was 31.6%. Of the 87 patients,57 cases were overcorrected and 30 cases were undercorrected. All the 87 patients were able to accept postoperative adjustment, The adjusted fixation position were satisfled. Conclusion This new technique is particularly suitable for pediatric surgery because it present a chance for correction with topical anesthesia during early postoperative period.

关 键 词：斜视 眼外肌 调整缝线 

分 类 号：R777.4[医药卫生—眼科]