不同下斜肌前转位术式治疗分离性垂直偏斜的疗效评价  

Evaluation of anterior transposition of the inferior oblique muscle with and without resection in the treatment of dissociated vertical deviation

作　　者：段辉[1] 罗肇文[1] 孙志河[1] 

机构地区：[1]大连医科大学附属第一医院眼科,116011

出　　处：《中国医师进修杂志》2011年第15期23-25,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 评价标准下斜肌前转位术和下斜肌前转位联合部分切除术在分离性垂直偏斜（DVD）治疗中的效果.方法 DVD患者36例（59眼）,按随机数字表法分为两组,标准下斜肌前转位术组（30眼）和下斜肌前转位联合部分切除术组（29眼）,观察对比术后3个月时的垂直斜视度变化和下斜肌功能状况.结果 标准下斜肌前转位术组30眼术后3个月第一眼位垂直斜视度为0△～10△（3.5△±2.7△）（三棱镜度）,下斜肌前转位联合部分切除术组29眼术后3个月第一眼位垂直斜视度为0△～12△（3.3△±3.6△）,两组比较差异无统计学意义（P＞0.05）.术后3个月标准下斜肌前转位术组下斜肌功能2眼为＋2级,7眼为＋1级,21眼为0级,下斜肌前转位联合部分切除术组下斜肌功能1眼为＋2级,4眼为＋1级,24眼为0级,两组比较差异无统计学意义（P＞0.05）.两组术后均未出现下斜视.结论 下斜肌前转位术可作为治疗DVD的首选术式,并可用于不伴有下斜肌功能亢进的DVD治疗.下斜肌前转位联合部分切除术并没有显著增加手术效果.Objective To assess the clinical effect of anterior transposition of the inferior oblique muscle （ATTO） with and without resection in the treatment of dissociated vertical deviation （DVD）. Methods Thirty-six patients （ 59 eyes ） with DVD were divided into the standard group （ 30 eyes） and the resection group （29 eyes） by random digits table undertaking ATIO with and without a 7-mm resection. The vertical deviation degree in primary position and the eyeball motility were recorded and evaluated. Results The vertical deviation degree in primary position were 0△-10△ （3.5 △± 2.7△） after 3 months operation in the standard group,while 0△-12△ （3.3△±3.6△） in the resection group. There were no significant differences between two groups （P〉 0.05）. In the standard group, 2 cases revealed ＋2 inferior oblique muscle overaction （IOOA）, 7 cases revealed ＋1 and 21 cases revealed 0 after 3 months operation. In the resection group, 1 case revealed ＋2 IOOA, 4 cases revealed ＋1 and 24 cases revealed 0 after 3 months operation. There were no significant differences between two groups（P〉 0.05 ）. The presence or absence of IOOA did not influence the result of ATIO for either group. Conclusions ATIO is an effective treatment for DVD and can be used to treat DVD in patients without IOOA. A 7-mm resection with the standard ATIO has no advantage to improve the surgery outcome.

关 键 词：眼外科手术 分离性垂直偏斜 下斜肌亢进 

分 类 号：R779.6[医药卫生—眼科]