视觉训练对共同性斜视患者术后眼位控制及双眼视觉功能重建疗效的临床研究  

Effects of visual training on eye position control and binocular visual function reconstruction for concomitant strabismus patients after surgery

作　　者：孟昭君 付晶 李蕾 赵博文 马楠 褚航 Meng Zhaojun;Fu Jing;Li Lei;Zhao Bowen;Ma Nan;Chu Hang(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Ophthalmology&Visual Sciences Key Lab.,Beijing 100730,China;National Engineering and Technology Research Center for Medical and Healthcare 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）》2021年第3期166-172,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(Z171100001017066);北京市卫生和计划生育委员会首都卫生发展科研专项重点攻关项目(首发2018-1-2051);北京市卫生系统高层次卫生技术人才-学科骨干项目(2015-3-023)。

摘　　要：目的比较不同视觉训练方式对年龄≥9岁的共同性斜视患者术后的眼位控制及双眼视觉功能重建效果。方法纳入2017年1月至2017年9月于首都医科大学附属北京同仁医院眼科中心进行斜视矫正手术的共同性斜视患者133例。其中,男性67例,女性66例,年龄9-34岁,平均年龄(15.6±7.8)岁。于术后1周时,采用数字表法随机将患者分成观察组、传统双眼视觉训练组及视感知觉训练组。传统双眼视觉训练组和视感知觉训练组患者分别接受相应训练,与观察组全部完成术后1个月、3个月及6个月的眼部常规检查、斜视度检查、眼球运动检查、双眼视觉功能检查及视感知觉检查。以(x±s)描述患者的年龄和斜视度,采用单因素方差分析比较三组患者的年龄;以术后1周为基线,采用GLM重复测量多因素方差分析比较不同组别不同时间点患者的斜视度;以例数和百分比描述患者的性别、斜视类型、双眼同时视功能、融合功能及立体视功能,并采用卡方检验进行比较性别和斜视类型。采用广义估计方程GEE模型分析比较不同组别不同时间点三组患者的双眼同时视功能、融合功能及立体视功能。结果眼位控制方面,观察组、传统双眼视觉训练组及视感知觉训练组等三组患者术后3个月和6个月时术后组内比较看远斜视度和看近斜视度均较基线值(术后1周)显著增加,差异具有统计学意义(F_(远,近)=33.65,36.84;P<0.05);三组患者各时间点看远斜视度和看近斜视度组间及交互作用差异无统计学意义(F_(远,近)=0.38,0.63,0.22,0.55;P>0.05)。术后组内比较,视感知觉训练组术后1个月、3个月及6个月时水平偏移数值均较基线值显著降低,差异具有统计学意义(F_(水平)=7.80,P<0.05);三组患者知觉眼位水平偏移和垂直偏移各时间点组间及交互作用差异无统计学意义(F_(水平,垂直)=1.01,1.81,0.59,1.30;P>0.05);三组患者垂直偏移各时间Objective The aim of this study was to compare the effect of different training methods on eye position control and binocular visual function reconstruction for concomitant strabismus patients(≥9 years-old)after surgery.Methods 133 patients with concomitant strabismus who underwent strabismus surgery in Beijing Tongren Eye Center,Beijing Tongren Hospital affiliated to Capital Medical University from January to September 2017 were collected.There were 67 males and 66 females with an average age of(15.6±7.8)years-old(ranged from 9 to 34 years-old).After operation for one week,the patients were randomly divided into observation group,traditional binocular vision training group and visual perception training group.All patients completed the examination of strabismus degree,eye movement,binocular visual function and visual perception after operation for 1 month,3 months and 6 months.The age and strabismus degree of patients were described by(x±s).ANOVA was used to compare the age of three groups.GLM ANOVA of repeated measurement was used to compare the strabismus degree among different groups and time.The gender,strabismus types and the binocular visual function were described by the number and percentage.χ^(2) testing was used to compare the gender and strabismus types of three groups.GEE model was used to compare the binocular visual function among different groups and time.Results Both distant and near deviation degree of the observation group,traditional binocular vision training group and visual perception training group after operation for 3 and 6 months were significantly higher than the baseline values(after operation for 1 week)(F_(far,near)=33.65,36.84;P<0.05),but no significant difference was found among different groups at each time point(F_(far,near)=0.38,0.63,0.22,0.55;P>0.05).The horizontal deviation degree of the visual perception training group at 1 month,3 months and 6 months after operation was significantly lower than that of the baseline value(F=7.80,P<0.05).There was no significant differenc

关 键 词：共同性斜视 眼位偏斜 双眼视觉功能 视感知觉 

分 类 号：R779.6[医药卫生—眼科]