儿童眼部手术后弱视综合治疗临床分析  

Clinical analysis of children＇ s amblyopia treated with comprehensive therapy after ocular surgery

作　　者：石荣先[1] 方亚非[1] 张建华[1] 

机构地区：[1]河南大学第一附属医院眼科,河南开封475001

出　　处：《中华眼外伤职业眼病杂志》2013年第9期673-675,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价儿童眼部手术后弱视综合治疗的效果。方法回顾性分析224例（248眼）经综合治疗并随访2年以上的儿童眼部手术后弱视。按弱视成因分组：斜视177眼、上睑下垂24眼和白内障47眼；按弱视开始治疗的年龄分组：3～6岁95眼、7～9岁86眼、10～12岁67眼；按弱视程度分组：轻度弱视75眼、中度弱视81眼、重度弱视92眼。结果248眼儿童眼部手术后的弱视，治愈134眼（54．03％），好转40眼（16．13％），无效74眼（29．84％），有效率为70．16％。斜视术后弱视治疗效果最好，上睑下垂者次之，二者之间差异无统计学意义（χ2=6．10，P〉0．05），但二者与白内障术后弱视治愈率之间差异均有统计学意义（χ2=11．23，P〈0．05;χ2=19．76，P〈0．01）；弱视治疗年龄越小，效果越好，三组之间差异有统计学意义（χ2=29．52，χ2=18．23,χ2=45．58，P〈0．01）；弱视程度越轻，效果越好，三组之间差异有统计学意义（χ2＝20．12,χ2＝17．23，P〈0．01；χ2=35．48，P〈0．01）。结论儿童眼部手术后的弱视尽早采用个体化综合治疗，方可取得较好效果。Objective To evaluate the efficacy of children＇ s amblyopia treated with comprehensive therapy after ocular surgery. Methods Retrospective analyzes 224 cases （ 248 eyes） of amblyopic children with comprehensive therapy after ocular surgery, which followed up for more than two years. According to causes, 177 eyes were strabismus, 24 eyes were ptosis, and 47 eyes were cataract. According to age of treatment, 95 eyes were in 3 to 6 years old, 86 eyes were in 7 to 9 years old, and 67 eyes were in 10 to 12 years old. According to degree, 75 eyes were mild, 81 eyes were medium and 92 eyes were serious. Results Among 248 eyes of children with amblyopia after ocular surgery, 134 eyes were cured （54.03%） , 40 eyes were improved （ 16.13% ） , 74 eyes were ineffective （29.84%） ; the effective rate was 70.16%. The efficacy of amblyopic treatment after strabismic surgery was the best, ptosis came to the second; statistical significance did not exist between the two （χ2 = 6. 10, P 〉 0.05 ） but existed with cataract surgery （χ2 = 11.23, P 〈0. 05 ; χ2 = 19.76, P 〈0.01 ）. The younger of the amblyopic children, the better came the effi- cacy; and there were statistical significance between three groups （χ2 =29.52, P 〈0. 01 ;χ2 = 18.23, P 〈 0. 01 ; χ2 =45.58, P 〈0.01 ）. The milder of the amblyopic degree, the better came the efficacy; and there were statistical significance between three groups （χ2 = 20. 12, P 〈 0. 01 ; χ2 = 17. 23, P 〈 0. 01 ; χ2 = 35.48, P 〈 0.01 ）. Conclusion Children with amblyopia after ocular surgery should adopt individualized comprehensive therapy as soon as possible in order to get satisfied efficacy.

关 键 词：儿童 眼部手术 弱视 综合治疗 疗效 

分 类 号：R777.44[医药卫生—眼科]