学龄前儿童与成人眼直肌滑车组织形态差异的观察  

Observation on the morphology differences of ocular rectus pulley between preschool children and adults

作　　者：韩晓梅[1] 赵堪兴[1] 

机构地区：[1]天津医科大学,300070

出　　处：《中华眼科杂志》2008年第10期912-915,共4页Chinese Journal of Ophthalmology

基　　金：国家自然科学基金资助项目（30371520）

摘　　要：目的观察学龄前儿童与成人眼直肌滑车组织形态的差异。方法实验研究。选取10例新鲜尸体眼眶（儿童组5例、成人组5例），整体固定包埋，全眼眶连续冠状切片（4μm）。相邻层面经Masson染色及苦味酸天狼猩红染色后，从大体角度和光镜下观察典型层面直肌滑车的组织结构。儿童组与成人组间比较采用具有一个重复测量两因素设计定量资料方差分析及相应的两两比较方法；两组内比较采用单因素两水平设计定量资料t检验。结果儿童与成人的眼直肌滑车均位于眼球赤道部直肌穿过Tenon囊的部位，为纤维环状结构，包绕每条眼直肌眶面，各直肌滑车之间形成连接带。儿童眼直肌滑车的长度、起始端至角巩膜缘距离，均低于成人组，差异有统计学意义（F=66．63，P〈0．05）。其组成成分与成人相仿，但内直肌滑车的平滑肌数量、Ⅲ型胶原含量明显高于成人组，差异有统计学意义（t=47．08，P〈0．05）；Ⅰ型胶原含量明显低于成人组，差异有统计学意义（t=36．25，P〈0．05）。结论学龄前儿童与成人眼直肌滑车组织形态间具有差异性，这一发现为更好地研究斜视病因提供了解剖学依据。Objective To study the morphology differences of ocular rectus muscles pulley between preschool children and adults. Methods It was an experimental research. Ten fresh cadaver orbits （ five children and five adults） were fixed in situ and serially sectioned at 4 μm thickness. Every section was stained with Masson＇s trichrome and picrosirius red methods. After being stained, extraocular muscle pulley in typical sections was examined through gross anatomy and light microscopy. Two-factor analysis of variance for quantitative data was used in statistical treatment. Results Near the equator of the globe, the children and adults＇ extraocular muscle pulleys were all at the points where the rectus penetrate posterior Tenon＇s fascia, encircling the rectus orbit side by fiber ring structure. There were pulley bands among rectus pulleys. The rectus pulley length and the origin distance from the corneoscleral limbus of the children were significantly less than those from the adult group （ P 〈 0. 05 ）. The main composition of the children rectus pulley was similar to that of the adults, but the smooth muscle and collagen type Ⅲ fibers contents of the medial rectus pulley in children were significantly greater than those in the adults group （P 〈0. 05 ）. Collagen type I fibers in the children were significantly less than that of the adults group （ P 〈 0.05 ）. Conclusion There are morphological differences in rectus pulley between preschool children and adults, which provides an anatomic basis for the better understanding of the pathogenesis of strabismus.

关 键 词：动眼肌 肌 平滑 人体测量术 儿童 学龄前 成年人 

分 类 号：R686[医药卫生—骨科学]