下斜肌断腱联合部分切除术对原在位水平斜视影响  

Effects on horizontal deviations in primary position of tenotomy combined with myectomy of inferior oblique muscle

作　　者：郑加庆[1] 刘桂香[1] 于淼[1] 顿月丽 

机构地区：[1]青岛大学附属医院眼科,266003

出　　处：《中国实用眼科杂志》2014年第6期750-753,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨下斜肌断腱联合部分切除术对原在位水平斜视的影响.方法 收集2012年1月至2013年3月单纯行下斜肌断腱联合部分切除手术治疗患者61例（68只眼）,其中54例患者行单侧手术,7例行双侧手术.术后随访3～12个月,测量术前、术后水平斜视度,记录内转、外转眼数,比较手术前后斜视度变化,统计手术前后变化量与术前斜视度的关系.结果 （1）手术前后视近水平斜视度变化：术后发生内转53只眼（53/68,77.94％）,内转度数3～25△,平均（6.58±4.05）△,手术前后水平斜视度比较,差异具有统计学意义（t =4.945,P＜0.001）.发生外转9只眼（9/68,13.24％）,外转度数2～5△,平均（3.71±0.97）△,手术前后水平斜视度比较,差异无统计学意义（t =1.906,P=0.093）.手术前后眼位无变化6只眼（6/68,8.82％）.（2）手术前后视远水平斜视度变化：术后发生内转50只眼（50/68,73.53％）,内转度数2～20△,平均（6.34±3.25）△,手术前后水平斜视度比较,差异具有统计学意义（t =4.911,P＜0.001）.发生外转12只眼（12/68,17.65％）,外转度数1～5△,平均（2.33±1.57）△,手术前后水平斜视度比较,差异无统计学意义（t=1.798,P=0.100）.手术前后眼位无变化6只眼（6/68,8.82％）.（3）水平斜视度变化量与术前水平斜视度大小呈正相关（r1=0.519,P＜0.001;r2=0.400,P2=0.002）.结论 单纯行下斜肌断腱联合部分切除术可影响原在位水平斜视度,且术前水平斜视度越大,术后水平斜视度变化越明显.Objective To evaluate the effect of the inferior oblique muscle tenotomy combined with myectomy on horizontal deviations in primary position.Methods From January 2012 to March 2013,6l cases （68 eyes） underwent tenotomy combines with myectomy of inferior oblique muscles as the sole without medial muscles surgery.Of the 61 patients,54 had unilateral inferior oblique muscle surgery,and then 7 had bilateral surgeries.Followed up for three to twelve months,and investigated the changes of horizontal deviations with the primary position after procedures as well as the relationship between the changes and preoperative horizontal deviations.Results 1.The changes angle of horizontal near deviation：There were 53 eyes （53/68,77.94%） esoshift after procedures,changed 3～25 △,（6.58±4.05）△,The comparison of angle of strabismus showed significant difference pre-and post-operation （t =4.945,P 〈0.001）.Nine eyes （9/68,13.24%） exoshift 2～5 △,（3.71±0.97） △,showed no difference pre-and post-operation （t =1.906,P =0.093）.Six eyes （6/68,8.82%） had no alteration of the deviation in primary position.2.The changes angle of horizontal distance deviation：There were 50 eyes （50/68,73.53%） esoshift,changed 2～20△,（6.34±3.25）△,The comparison showed significant difference pre-and post-operation （t =4.911,P 〈0.001）.There were 12 eyes （12/68,17.65%） exoshift 1～5△,（2.33 ±1.57）△,showed no difference pre-and post-operation （t =1.798,P =0.100）.Six eyes （6/68,8.82%） had no alteration of the deviation in primary position.3.There was positive correlation between the change and preoperative horizontal deviations （r 1=0.519,P 1〈0.001; r 2=0.400,P 2=0.002）.Conclusions The inferior oblique muscle tenotomy combined with myectomy can affect the horizontal deviations in primary position.

关 键 词：斜视 下斜肌 外科手术 眼位 

分 类 号：R657.4[医药卫生—外科学]