改良Parks切口直肌调整缝线术对儿童水平斜视术后眼球屈光状态变化的影响探究  

Effect of improved Parks incision rectus muscle adjusting suture on the refractive state of children after horizontal strabismus surgery

作　　者：滑会兰[1] 苏鸣[1] 陈璐[1] 尚李娅[1] 刘丽芳 HUA Hui-lan;SU Ming;CHEN Lu;SHANG Li-ya;LIU Li-fang(Department of Ophthalmology,Children's Hospital of Hebei Province,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院眼科,石家庄050031

出　　处：《中国医学前沿杂志（电子版）》2019年第3期95-99,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：河北省医学科学研究重点课题计划项目(1120140798)

摘　　要：目的探讨改良Parks切口直肌调整缝线术对儿童水平斜视术后眼球屈光状态变化的影响。方法选取2016年1月至2017年9月本院收治的110例(147眼)水平斜视患儿为研究对象。按照简单随机法将入选患儿分为对照组和观察组,每组各55例。对照组患儿采用常规切口进行直肌调整缝线术,观察组患儿采用改良Parks切口进行直肌调整缝线术。比较两组患儿的治疗效果、手术前后眼球屈光度和角膜曲率差值以及并发症发生情况。结果观察组患儿治疗有效率显著高于对照组(P <0.05)。术后1周,观察组患儿手术前后球镜屈光度差值大于对照组(P <0.05);术后1个月、2个月、4个月、8个月,两组患儿手术前后球镜屈光度差值比较均无显著差异(P_均> 0.05)。术后1周和1个月,观察组患儿柱镜屈光度差值均显著大于同期对照组(P_均<0.05);术后2个月、4个月、8个月,两组患儿柱镜屈光度差值比较均无显著差异(P_均> 0.05)。术后1个月,观察组患儿中央、鼻侧、颞侧、下方角膜曲率差值大于对照组(P_均<0.05),两组患儿上方角膜曲率差值比较无显著差异(P> 0.05);术后2个月,两组患儿中央、鼻侧、颞侧、上方、下方角膜曲率差值比较均无显著差异(P_均> 0.05)。两组患儿不良反应发生率比较无显著差异(χ~2=0.927,P> 0.05)。结论改良Parks切口直肌调整缝线术治疗儿童水平斜视效果显著,可改善眼球屈光度,且安全性较高,值得推广应用。Objective To investigate the effect of improved Parks incision rectus muscle adjusting suture on the refractive state of children after horizontal strabismus surgery.Method From January 2016 to September 2017,110 children(147 eyes)with horizontal strabismus admitted to our hospital were selected as subjects.They were divided into two groups according to the simple random method,55 cases in each group.Control group children were treated with rectus adjustment suture through conventional incision.Observation group children were treated with improved Parks incision to rectus adjustment suture.The therapeutic effect,the difference of diopter and corneal curvature before and after operation,and the incidence of complications were compared between the two groups.Result The effective rate of treatment in observation group was significantly higher than that in control group(P<0.05).One week after operation,the difference of spherical diopter before and after operation in observation group was larger than that in control group(P<0.05);1 month,2 months,4 months and 8 months after operation,there were no significant differences in the spherical diopter between the two groups(Pall>0.05).1 week and 1 month after operation,the changes of columnar refraction in observation group were significantly larger than those in control group(Pall<0.05);there were no significant differences in the difference of columnar refraction between the two groups at 2,4 and 8 months after operation(Pall>0.05).1 month after operation,the difference of corneal curvature between the central,nasal,temporal and inferior corneas in observation group was larger than that in control group(Pall<0.05),but there was no significant difference in the difference of corneal curvature between the two groups(P>0.05).2 months after operation,there were no significant differences in the difference of corneal curvature between the two groups in central,nasal,temporal,upper and lower corneas(Pall>0.05).There was no significant difference in the incidence of adverse rea

关 键 词：改良Parks切口 直肌调整缝线术 水平斜视 屈光度 

分 类 号：R779.6[医药卫生—眼科]