内直肌止端前移在大度数共同性外斜视矫正术中的应用  

Application of medial rectus muscle towards the front of its stop spot to correct large angle concomitant exotropia

作　　者：李恒[1] 刘志刚[1] 米雪[2] 

机构地区：[1]四川遂宁市中心医院眼科,629000 [2]四川遂宁市中心医院消化内镜中心,629000

出　　处：《中华眼科医学杂志（电子版）》2015年第5期37-40,共4页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

摘　　要：目的评估内直肌止端前移在大度数共同性外斜视矫正术中的临床效果。方法收集2011年1月至2014年12月四川遂宁市中心医院眼科收治的96例(192只眼)大度数共同性外斜视患者的临床资料。按照数字表法随机分为实验组和对照组,每组各48例(96只眼)。两组患者均实施双眼外直肌后退联合眼内直肌部分切除术进行治疗。其中,实验组患者对部分切除的内直肌实施止端前移操作;对照组患者对部分切除的内直肌采取按传统方式把切除后的肌肉固定缝合于残余肌肉止端上。实验组与对照组两组患者手术后6个月时的眼位正位及欠矫情况,采用例数和百分比的方式进行描述。此外,实验组与对照组两组患者手术后6个月时患者的眼位正位情况的统计学分析,系采用χ2检验进行比较。结果在实验组48例(96只眼)患者中,术后患者眼位正位者45例(90只眼),正位率为93.75%;欠矫者3例(6只眼),欠矫率为6.25%。在对照组48例(96只眼)患者中、术后患者眼位正位者38例(76只眼),正位率为79.17%;欠矫者10例(20只眼),欠矫率为20.83%。两组患者眼位术后正位数差异有统计学差异(χ2=4.3595,P<0.05)。在本研究全部96例(192只眼)患者中术后眼位未恢复正位的13例(26只眼)患者主要表现为欠矫,欠矫率为13.54%。结论内直肌止端前移矫正大度数共同性外斜视的手术方式安全可靠,并且在矫正大度数共同性外斜视方面较传统术式能够获得更高的术后正位率。Objective To evaluate the efficiency of medial rectus muscle towards the front to correct large angle concomitant exotropia. Methods A randomized sequential comparison study was designed in which 96 patients with large angle concomitant exotropia who were divided into experimental group and control group,96 patients were treated by double lateral rectuses recession and partial resection of an medial rectus muscle, but the medial rectus muscle was moved towards the front of its stop spot in experimental group;the medial rectus muscle was sew up at its its stop spot. The post-operative outcomes of two groups were compared and analysed. Results 45 patients were orthotropia, accounting 93.75% in experimental group;38 patients were orthotmpia,accounting 79.17% in control group,There was significant difference in the orthotropia rate between the two groups （X2 = 4. 3595, P 〈 0. 05 ） , 13 patients who did not recover orthotropia were due to the insufficient quantity of correction in operation. Conclusion The operation of medial rectus muscle towards the front to correct large angle concomitant exotropia is safety,it can increase the the orthotropia rate of large angle concomitant exotropia.

关 键 词：内直肌 大度数 共同性外斜视 

分 类 号：R779.6[医药卫生—眼科]