不同训练方式对间歇性外斜视患者术后斜视度及双眼视觉功能的疗效观察  

Effect of different training methods on strabismus and binocular visual function for postoperative patients with intermittent exotropia

作　　者：李蕾 付晶 孟昭君 赵博文 阎丽 Li Lei;Fu Jing;Meng Zhaojun;Zhao Bowen;Yan Li(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Ophthalmology&Visual Sciences Key Laboratory,Beijing 100730,China;National Engineering and Technology Research Center for Medical and Health Care Appliances,Guangzhou 510500,China)

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室,100730 [2]国家医疗保健器具工程技术研究中心,广州510500

出　　处：《中华眼科医学杂志（电子版）》2020年第1期20-26,共7页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：首都特色临床应用研究专项课题(Z171100017066);北京市卫生系统高层次卫生技术人才学科骨干(2015-3-023)。

摘　　要：目的 比较不同训练方式对间歇性外斜视患者术后斜视度及双眼视觉功能的疗效.方法 前瞻性研究.收集北京同仁医院北京同仁眼科中心2017年1 月至2017 年9 月间歇性外斜视且进行斜视矫正术者312 例.其中,男性162 例,女性150 例,年龄3~36 岁,平均(11.3±7.3)岁.根据术后1 周开始不同训练的需要,采用数字表法随机将患者分为观察组(102 例)、传统训练组(105 例)及视感知训练组(105 例).检查并记录患者训练前、训练后1 个月、训练后3 个月及训练后6个月时的远近斜视度、同视机三级功能恢复率及近立体视恢复率.采用广义线性混合效应线性模型,对上述指标进行比较.结果 训练前、训练后1 、3 个月及6 个月三组平均看近斜视度分别为(0.68±2.08)△、(1.45±3.19)△、(1.74±3.69)△及(2.36±4.48)△.训练后 1 个月、3 个月及6个月与训练前比较差异有统计学意义(t=2.57,2.98,3.54;P<0.05).看远斜视度分别为(0.70±2.15)△、(1.45±3.19△、(1.78±3.72)△及(2.42±4.5 1)△.训练后1 个月、3 个月及6 个月与训练前比较差异有统计学意义(t=2.35,2.75,3.67;P<0.05).同视机Ⅰ级功能恢复率,术后均达到95%以上,三组的组间差异无统计学意义(F=0.92,P>0.05).同视机Ⅱ级功能恢复率,训练后3 个月比训练前增加16例(占9.25%),其差异有统计学意义(F=4.32,P<0.05);训练后6 个月比训练前及训练后1 个月分别增加23 例(占 13.29%)及20 例(占 11.56%),其差异有统计学意义(F=6.15,5.17;P<0.05).同视机Ⅲ级功能恢复率,视感知觉组训练后3 个月及6 个月比训练前分别增加17例(占31.48%)及21 例(占38.89%),其差异有统计学意义(F=10.80,16.34;P<0.05);传统训练组训练后3个月及6个月比训练前分别增加13例(占20.64%)及14例(占22.20%),其差异有统计学意义(F=5.36,6.22;P<0.05).近立体视恢复率,训练后3 个月比训练前增加22 例(占12.87%),其差异有统计学意义(F=6.28,P<0.05);训练后6个月比Objective To compare the effect of different training methods on strabismus and binocular visual function for postoperative patients with intermittenl exotropia.Methods Prospeclixe randomized controlled study.312 patients with intermiltent exotropia who untlenvent strabismus surgeiy from January to September 2017 in Beijing Tongren Hospital were recruited,including 162 males and 150 females,age(3 to 36)with an average age of(11.3±7.3)years-old.According to the table of Random Numbers,patients were divided into three groups,including observation group(102),traditional binocular vision Iraining grouj)(105)and visual perception training group(105).The patients were followed up at before and 1,3 and 6 months after training.Generalized Unecir Mixed Effec t Linear Model was used to the strabismus and binocular visual finictioii before and 1,3,and 6 months after training.Results The near stmbisnius hefore*training,after tiainiiig in 1,3,and 6 months was(0.68±2.08)A,(1.45±3.19)△,(1.74±3.69)△ ami(2.36±4.48)△,respectively.Hie comparison between 1,3 and 6 months after training anti beforerain in g、vas statistically significant(F=2.57,2.98,3.54;P<0.05).The far stml)ismus before Iraining,after training;in 1,3,and 6 months were(0.70±2.15)△,(1.45±3.19)△,(1.78±3.72)△ aii(l(2.42±4.51)A,resperlivdy.The(.om[mi.is(ms between 1,3 and 6 months after training and Ijefore training were statistically significant(F=2.35,2.75,3.67;P<0.05).The recoveiy rate of grade I hinoc ular funt-tion after ojjeration was more than 95%;there were no significant differences in groups(F=0.92,P>0.05).The recover)rate of grade Ⅱ binoc-ular(unction from 16 rases accouting for 9.25%was higher at 3 months after training than at before tiaining,and their comparisons were statistically significanl(F=4.32,P<0.05).The recoveiy rates of grade Ⅱ hinocular function from 23 cases accouting lor 13.29%and 20 cases accouting for 11.56%were higher at 6 months after training than at 1 month after training,and their comjwisons were statistically s

关 键 词：间歇性外斜视 视感知觉训练 双眼视觉功能 重复测量 

分 类 号：R779.6[医药卫生—眼科]