下斜肌减弱术治疗上斜肌麻痹性斜视163例的临床观察  

The therapeutic effects of inferior oblique weakening surgery for 263 superior oblique paralysis patients

作　　者：李平 吕绍成 

机构地区：[1]辽宁省盘锦市第四人民医院,124000

出　　处：《中国实用医药》2011年第10期17-19,共3页China Practical Medicine

摘　　要：目的探讨不同的下斜肌减弱术在治疗上斜肌麻痹性斜视中的疗效。方法对2004年7月至2010年6月收治上斜肌麻痹性斜视163例,分别行下斜肌部分切除前转位术或下斜肌断腱术、下斜肌后徙术及下斜肌截腱联合同侧上直肌或对侧下直肌后徙术。结果 163例中合并DVD8例。术前118例有代偿头位,术后代偿头位消失73例(61.86),好转40例(33.89),无效5例(4.23)。单纯下斜肌减弱术163例中治愈142例(87.12),好转12例(7.36),无效6例(3.68),过矫3例(1.84)。结论先天垂直性麻痹临床表现复杂,手术方式不一,灵活选择不同的手术方式可收到较好效果。下斜肌部分切除前转位术的平均矫正量高于下斜肌后徙及下斜肌断腱术。在行下斜肌部分切除转位术时,一定要截除足量的下斜肌,一般为6～8mm,这样才能使下斜肌的上转作用转变为下转作用因而使其减弱效果更为明显。Objective To discuss the therapeutic effects of different inferior oblique muscles weakening surgery for superior oblique paralysis.Methods 163 patients with superior oblique paralysis from Jul 2004 to Jun 2010 were performed inferior oblique muscle myectomy and anterior transposition,recession,myectomy and tenotomy.Results 118 cases had head posture pre-operation,73 cases disappeared post-operation（61.86%）,40 cases was better（33.89%） and 5 cases was of no effect（4.23%）.Finally,142 cases were cured（87.12%）,12 cases were improved（7.36%）,6 cases received no effectiveness（3.68%） and 3 cases overcorrected（1.84%）.Conclusion The clinic symptoms are complicated and the surgery methods are various for superior oblique paralysis,we should choose proper surgery method.The mean corrective data of myectomy and anterior transposition is higher than other methods.During this operation,we should resect inferior oblique enough to weaken the power,commnly 6~8 mm.

关 键 词：下斜肌 前转位术 垂直性斜视 

分 类 号：R779.6[医药卫生—眼科]