后部肌间缝线加强上亘肌转位木治疗外展神经麻痹性斜视观察  

Observation of superior rectus transposition with posterior intermuscular suture for abducent paralytic strabismus

作　　者：杨珺[1] 李倩[1] 赵淑静[1] Yang Jun Li Qian Zhao Shujing.(Department of Ophthalmology, The Second People＇s Hospital of Jinan, Jinan 250001, China)

机构地区：[1]济南市第二人民医院眼科,济南250001

出　　处：《中国实用眼科杂志》2017年第6期598-600,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察后部肌间缝线加强的上直肌完全转位术治疗外展神经麻痹性斜视的术中及术后疗效。方法回顾性系列病例研究。收集济南市第二人民医院于2014年4月至2015年12月采用内直肌后徙联合后部肌间缝线加强的上直肌移植术矫正完全性外展神经麻痹所致内斜视21例21只眼，对术前、术中及术后6个月眼位情况进行观察及分析。结果完全性外展神经麻痹21例行内直肌后徙联合后部肌间缝线加强的上直肌移植术矫正术，术中观察上直肌完全转位于外直肌止端上方矫正内斜（12±3.2）°，上直肌与外直肌止端后8 mm处行后部肌间缝线加强术后矫正内斜（4.2±1.6）°,内直肌后徙6~10 mm，矫正内斜（14.5±4.2）°，术后内斜矫正效果显著，患者复视现象明显减轻，患眼外转较术前改善，术后未引起明显的垂直及旋转性斜视。随诊6月至2年，已矫正眼位稳定，疗效显著。结论后部肌间缝线加强的上直肌转位术治疗外展神经麻痹性斜视是可行的，且疗效稳定。Objective To observe the effective of superior rectus transposition with posterior rectus transposition with posterior intermuscular suture for treatment of abducent paralytic strabismus. Methods A retrospection study, Totally 21 cases （21 eyes） of severe esotropia caused by abducent paralysis were treated by superior rectus transposition with posterior intermuscular suture. The cases were collected from April 2014 to December 2015 in our hospital. The position of eye in preoperation, during operation and postoperation were analyzed. Results Treated by superior rectus transposition with posterior intermuscular suture and medial rectus recession, during operation, superior rectus transposition corrected internal oblique 12±3.2o posterior intermuscular suture of superior rectus and external rectus corrected internal oblique 4.2±1.6o medial rectus recession 6-8mm, corrected internal oblique 14±4.2o Esotropia of 21 cases were corrected significantly. Apparent improvement was ob- tained in paralytic eye. No significant vertical and rotational strabismus was induced. After 6 months to 2 years follow-up, the eye position kept stable and no obvious change occurred. Conclusions Superior rectus transposition with posterior intermuscular suture in treating abducent paralytic strabismus is feasible and its outcome is stable.

关 键 词：上直肌转位 后部肌间缝线 外展神经麻痹 

分 类 号：R777.41[医药卫生—眼科]