压抑疗法与遮盖法治疗儿童单眼中重度弱视的比较  

TREATMENT OF DEPRESSION THERAPY AND COVER THE EYES OF CHILDREN IN SINGLE-COMPARISON OF MODERATE AND SEVERE AMBLYOPIA

作　　者：渠继芳[1] 李璐[1] 

机构地区：[1]上海交通大学医学院附属儿童医学中心眼科,上海200127

出　　处：《现代预防医学》2009年第24期4696-4698,共3页Modern Preventive Medicine

摘　　要：[目的]研究压抑疗法与遮盖法治疗对儿童单眼中重度弱视的临床疗效和对立体视重建的影响,并对两种方法的依从性进行比较。[方法]选取254例3～10岁单眼中重度弱视儿童,随机分成2组,126例为压抑组,弱视眼过矫+2.50D,优势眼作全部屈光矫正或调整优势眼屈光度,使优势眼戴镜视力低于弱视眼,隔天晚上涂1%阿托品眼膏于优势眼下睑结膜囊内,施行近压抑;128例为遮盖组,弱视眼配适矫镜,优势眼每天遮盖6h或以上。在9个月时从视力恢复和Titmus立体视重建两方面进行疗效比较,并比较患儿及家长对两种方法的依从性。[结果]压抑组疗效的总有效率为84.3%;遮盖组为85.1%;两者差异无统计学意义(P=0.8764,P﹥0.05)。Titmus立体视重建压抑组为37例,有效率为72.5%;遮盖组为29例,有效率为53.7%;两者差异有统计学意义(P=0.0458,P﹤0.05)。两组的依从性分别为74.8%和57.9%,差异有统计学意义(P=0.0138,P﹤0.05)。[结论]本研究显示压抑疗法与遮盖法在治疗儿童单眼中重度弱视具有同等的临床疗效;对立体视重建压抑疗法优于遮盖法;依从性压抑疗法优于遮盖法。[Objective] To investigate the efficacy,the impact to stereopsis reconstruction and the compliance of penalization and occlusion treatment to children with moderate to severe one-eyed amblyopia.[Methods] 254 children with amblyopia were randomly divided into 2 groups,126 cases received penalization treatment,were added ＋2.50 D based on original diopter to amblyopia eye,made refractive corrections to sound eye or adjust the scale of ophthalmic glass to make visual acuity lower than amblyopia eye and gave 1% atropine ointment in conjunctivas of lower eyelid every other day;128 cases received occlusion treatment,amblyopia eye weared corrected glasses,sound eye was covered for 6 hours or above every day.We com-pared the recovery efficacy of visual and Titmus stereopsis at month 9,and compared the compliance of patients and their parents between the two treatment methods.[Results] Total effective rate of penalization group and occluding group were 84.3% and 85.1%,respectively,and there was no statistical significant differences（P=0.8764,P﹥0.05）.There were 37 and 29 cas-es in two groups reached recovery of Titmus stereopsis.The effective rates were 72.5% and 53.7%,respectively,and there was statistically significant between the two groups（P﹤0.05）.The compliance rates between the two groups also showed significant-ly difference.[Conclusion] In children with moderate to severe one-eyed amblyopia,penalization treatment and occlusion treatment has the same clinical efficacy;stereopsis penalization is superior than occlusion therapy,and the compliance as well.

关 键 词：压抑疗法 遮盖法 弱视 立体视 依从性 

分 类 号：R777.44[医药卫生—眼科]