后天性外展神经全麻痹的手术治疗  

The efficacy of Faden procedure combined with Jensen procedure in patients with complete abducens nerve palsy

作　　者：戴淑真[1] 张黎[1] 王莉红[1] 王丽娅[1] 

机构地区：[1]河南省眼科研究所,郑州450003

出　　处：《中国实用医药》2012年第10期20-21,共2页China Practical Medicine

摘　　要：目的回顾性分析内直肌Faden后固定术联合外直肌Jensen肌肉连接术治疗后天性外展神经全麻痹的疗效。方法 26例后天性外展神经全麻痹的患者在我科行内直肌Faden后固定术联合外直肌Jensen肌肉连接术,应用同视机、三棱镜、线状镜等观察手术前后斜视度、眼球运动、代偿头位及双眼视觉的改变。结果术后1年,26例患者中有24例斜视度在+15△以下,手术成功率为92.31%,与术前相比所有患者眼球运动明显改善,除2例患者术后并发内直肌挛缩需要二次手术外,其余患者代偿头位消失,并恢复了双眼单视功能。结论内直肌Faden后固定术联合外直肌Jensen肌肉连接术是治疗后天性外展神经全麻痹的有效方法。Objective Patients with the sixth nerve palsy that does not resolve within 6 months should undergo surgery. The aim of our study was to evaluate the results of Jensen procedure combined with Faden pro- cedure performed in patients with acquired complete ahdueens nerve palsy. Methods Twenty-six cases of abdueens nerve palsy ware retrospectively analyzed. All patients underwent full ophthalmic and orthoptic examination with synoptophore and prism before and after surgery. All patients underwent Jensen procedure to the lateral rec- tus insertion and Faden procedure to the medial rectus in the affected eye. Results In all cases, we found a va- rying degree of postoperative improvement. There was a significant reduction in the strabismus angle for distance and near, the angle of 24 patients was below 15 prism and the successful rate was 92. 31%. Increase in abduction of the affected eye, recover of binocular single vision and the improvement of the head postures were found. Conclusion Jensen procedure combined with Faden procedure is a safe and successful method of treatment in complete abducens nerve palsy. It allows one to achieve orthophoria, improvement of abduction, normal head posture and larger field of binocular single vision.

关 键 词：Faden术 Jensen肌肉连接术 外展神经全麻痹 斜视 

分 类 号：R779.6[医药卫生—眼科]