小儿脑外伤所致展神经麻痹非共同性斜视的手术治疗  

The surgical treatment for noncomitant strabismus due to paralysis of abducent nerve caused by brain trauma in children

作　　者：孙晓宇 崔国义 Sun Xiaoyu;Cui Guoyi(Department of Children's Strabismus and Amblyopia,Zhoukou AIER Eye Hospital,Henan 466000,China)

机构地区：[1]周口爱尔眼科医院小儿斜视与弱视科,河南466000

出　　处：《中华眼外伤职业眼病杂志》2019年第10期775-779,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨小儿脑外伤所致展神经麻痹非共同性斜视的手术治疗方法.方法对2017年1月至2018年12月该院收治的脑外伤后出现展神经麻痹非共同性斜视患儿33名(33眼)的临床资料进行回顾性分析.其中包括完全性麻痹与不全麻痹,均实施内外直肌移位术.观察手术效果.结果治疗后斜视度显著低于治疗前(P=0.000),眼球运动幅度大于治疗前(P=0.000),头位偏移角度小于治疗前(P=0.000),均获得第一眼位正位,复视症状完全消失,代偿性头位消失或得到显著改善.术后随访,角膜映光均为正位,同视机检查为+2°^+9°,外转功能恢复至5°~10°.结论小儿脑外伤所致展神经麻痹非共同性斜视行手术治疗,效果良好.Objective To investigate the surgical treatment for noncomitant strabismus due to paralysis of abducent nerve caused by brain trauma in children.Methods The clinical data of 33 eyes of 33 children with noncomitant strabismus due to paralysis of abducent nerve caused by brain trauma in this hospital from Jan.2017 to Dec.2018 were retrospectively analyzed.There were complete paralysis and paresis.Both medial and external rectus muscle transposition were performed to all cases.The surgical efficacy was observed.Results The strabismus degree after treatment was significantly lower than that before treatment(P=0.000),eye movement amplitude after treatment was significantly higher than that before treatment(P=0.000),and head position deviation angle after treatment was significantly lower than that before treatment(P=0.000).All cases obtained normal ocular alignment in primary position after operation.Diplopia symptoms completely disappeared,and compensatory head position disappeared or significantly improved.Follow-up after surgery showed that the cornea optical reflection was positive,the synoptophore results was+2°-+9°,and the abduction degree was restored to 5°-10°Conclusion Surgical treatment for noncomitant strabismus due to paralysis of abducent nerve caused by brain trauma in children is effective.

关 键 词：外伤 脑 小儿 麻痹 展神经 斜视 非共同性 

分 类 号：R65[医药卫生—外科学]