双眼外直肌后徙术治疗儿童间歇性外斜视的效果观察  

Clinical observation on the efficacy of bilateral rectus recession for the treatment of intermittent exotropia in children

作　　者：李秀贵[1] 冯清霞 Li Xiugui;Feng Qingxia(Department of Ophthalmology,Heze Municipal Hospital,Shandong 274000,China)

机构地区：[1]菏泽市立医院眼科,山东274000

出　　处：《中华眼外伤职业眼病杂志》2020年第9期670-675,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察双眼外直肌后徙术治疗儿童间歇性外斜视的效果.方法前瞻性分析菏泽市立医院2017年4月至2018年11月儿童间歇性斜视76例的临床资料.所有患者随机分为两组:常规组38例,以单眼外直肌后徙联合内直肌缩短术治疗;研究组38例,以双眼外直肌后徙术治疗,术后随访1年.比较两组的效果.结果术后两组间无立体视、周边立体视、黄斑立体视和中心立体视者的比例差异无统计学意义(P=0.640、0.692、0.666和0.655);术后1周的眼位正位率、过矫率和欠矫率两组之间差异均无统计学意义(P>0.05);术后1年研究组的正位率为78.95%(30/38)高于常规组的65.79%(25/38),P=0.037.研究组术后1年的斜视度(-2.542±4.315)PD和斜视退回量(4.375±2.279)PD分别少于常规组的(-6.536±6.682)PD和(9.068±3.824)PD,差异有统计学意义(P=0.003,0.001).结论对儿童间歇性外斜视双眼外直肌后徙术治疗效果更加显著.Objective To observe the efficacy of bilateral rectus recession in the treatment of intermittent exotropia in children.Methods This was a prospective analysis.The clinical data of 76 children with intermittent exotropia in Heze Municipal Hospital from Apr.2017 to Nov.2018 were analyzed.All cases were randomly divided into two groups,38 cases in each group.The routine group were treated with unilateral external rectus recession combined with internal rectus shortening,and the study group were treated with bilateral external rectus recession.The follow-up time was 1 year.The treatment efficacy were compared in the two groups.Results The differences in the proportion of patients without stereopsis,peripheral stereopsis,macular stereopsis and central,were not significant between the two groups(P=0.640,0.692,0.666,0.655).There was no significant difference in the rate of eye position,over correction rate or under correction rate between the two groups at 1 week after operation(P>0.05).At 1 year after operation,the normal positive rate in the study group was 78.95%(30/38),which was higher than that 65.79%(25/38)in the routine group(P=0.037).At 1 year after operation,the strabismus degree was(-2.542±4.315)PD and strabismus return amount was(4.375±2.279)PD in the study group,which were lower than those in the routine group(-6.536±6.682)PD and(9.068±3.824)PD,and the difference were statistically significant between the two groups(P=0.003,0.001).Conclusion Bilateral rectus recession is more effective in the treatment of children’s intermittent exotropia.

关 键 词：外斜视 间歇性 儿童 后徙术 外直肌 双眼 效果 治疗 

分 类 号：R779.6[医药卫生—眼科]