儿童屈光不正性弱视治疗效果相关因素分析  

The related factors analysis of efficacy of treatment for the children with ametropic amyoplyopia

作　　者：时颖[1] 郑曰忠[1] 

机构地区：[1]天津市眼科医院验光配镜中心天津市眼科学与视觉科学重点实验室天津医科大学眼科临床学院,300020

出　　处：《中国实用眼科杂志》2015年第6期654-656,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的分析屈光不正性弱视患儿的年龄因素、弱视类型和治疗方法对弱视治疗效果的影响。方法临床病例系列研究。自2009年1月至2012年4月间，在天津市眼科医院的验光配镜中心收集弱视训练矫正的屈光不正性弱视患儿265例（450只眼），其中男126例，女139例，平均年龄（6．7±2．4）岁（3～12岁）。根据患儿弱视程度和依从性，对所有患儿分别采用验光配镜、遮盖、压抑或综合治疗方法进行矫正，并随访观察其疗效。结果265例（450只眼）弱视患儿经治疗后最佳矫正视力均有不同程度提高，治疗前平均视力为0．39＋0．24，治疗后平均视力为0．72＋0．18，治疗前后视力差异有统计学意义（t=25．64，P=0．00）。总有效率为9014％（407／450），不同年龄组患儿有效率差异有统计学意义（H=16．33，P=0．00），其中3~5岁组患儿疗效（98．3％，234／238）最好，6—8岁组患儿疗效（86．8％，118／136）次之，9～12岁组患儿疗效（72．4％，55／76）较差。由远视导致的屈光不正性弱视患儿疗效最佳（97．9％，279／285），其次是近视性弱视（81．6％，102／125），而散光导致的弱视疗效最差（65．O％，26／40），三组患儿之间疗效差异有统计学意义（H=50．94，P=0．00）。采用验光配镜和遮盖相结合的综合治疗组患儿疗效（96．2％，256／266）明显高于单纯屈光矫正组（84．1％，116／138）和单纯压抑矫正组患儿（76．1％，35／46），疗效差异有统计学意义（H=11．84，P=0．00）。结论儿童屈光不正性弱视应在幼儿早期尽早采用综合治疗方法进行矫正治疗，其中远视性弱视患儿疗效明显。Objective To analyze the impact of age, type of amblyopia and treatment methods on the outcome of the children with ametropic amblyopia. Methods From January 2009 to April 2012, 265 cases （450 eyes） of patients with ametropic amblyopia were recruited in our optometry center. There were 126 cases with males and 139 cases with female. The average age was （6.7i2.4） years old （range from 3-12 years old）. The patients were treated with the comprehensive treatment, simple refractive correction or pure penalization therapy based on their amblyopic degree and compli- ance. The outcomes were observed and followed up. Results After the treatment and one year fol- lowed-up, the best corrected visual acuity （BCVA） of all amblyopic patients was improved with dif- ferent degree. The BCVA at initial visit and at the last visit were 0.39-0.24 and 0.72~0.18 respec- tively, and the difference was significant （t =25.64, P =0.00）. The total successful rate was 90.4% （407/450）, and the difference between the age groups was significant （H=16.33, P =0.00）. The suc- cessful rate was higher at age from 3 to 5 years old （98.3%, 234/238）, and following with the group of 6 to 8 years old （86.8%, 118/136） and the group of 9 to 12 years old （72.4%, 55/76）. The successful rate of the patients with hyperopic amblyopia （97.9%, 279/285） was better, following with myopic amblyopia （81.6%, 102/125） and astigmatic amblyopia （65.0%, 26/40）, and the differ- ence was significant （H=50.94, P =43.00）. The difference of successful rate with different type of treatment was significant （H=11.84, P =0.00）, and the comprehensive treatment group （96.2%, 256/ 266） was better than that of the simple refractive correction group （84.1%, 116/138） or pure penaliza- tion therapy group （76.1%, 35/46）. Conclusions The children with ametropic amblyopia should be treated as earlier in younger ages with comprehensive methods, especially more effective for the hy- peropic amblyopia.

关 键 词：儿童 屈光不正性弱视 综合治疗 疗效 

分 类 号：R777.44[医药卫生—眼科]