双眼外直肌后徙术对基本型间歇性斜视儿童视功能、多焦视觉诱发电位和生活质量的影响  

Effects of binocular external rectus recession on visual function,multifocal visual evoked potential and quality of life in children with basic intermittent strabismus

作　　者：苏丽萍 王珏 SU Liping;WANG Jue(Department of Ophthalmology,Tangdu Hospital,Air Force Medical University,Xi’an 710038,China)

机构地区：[1]空军军医大学唐都医院眼科,陕西西安710038

出　　处：《陕西医学杂志》2022年第8期948-952,共5页Shaanxi Medical Journal

基　　金：国家自然科学基金资助项目(81600720)。

摘　　要：目的:观察双眼外直肌后徙术对基本型间歇性斜视儿童视功能、多焦视觉诱发电位和生活质量的影响。方法:回顾性分析84例基本型间歇性斜视患儿的临床资料,其中43例行双眼外直肌后徙术治疗的患儿纳入A组,41例行单眼一退一截术治疗的患儿纳入B组。比较两组患儿斜视矫正效果以及术后立体视功能、视远斜视度、视近斜视度、外斜偏移量、眼部多焦视觉诱发电位。采用中文版斜视儿童生存质量量表(Child-IXTQ)评价患儿术前、术后1、3、6个月时的生活质量。结果:两组患儿术后1 d、1、3、6个月时的手术成功率比较差异无统计学意义(均P>0.05)。与术前比较,两组术后1、3、6个月时的无立体视患儿比例显著降低,中心立体视比例显著增加(均P<0.05)。两组患儿术后3、6个月时无远立体视比例显著低于术前和术后1个月时,差异有统计学意义(均P<0.05)。两组患儿不同时间近立体视锐度情况、无远立体视比例比较均无统计学差异(均P>0.05)。两组患儿术后1、3、6个月时的6 m斜视度和33 cm斜视度均显著低于术后1 d(均P<0.05)。两组患儿术后6个月时的P波离心环第4环和第6环特征峰振幅反应密度显著大于术前(均P<0.05),其余特征峰振幅反应密度与术前比较无统计学差异(均P>0.05)。A组患儿术后3、6个月时的外斜漂移量均显著小于B组(均P<0.05)。两组患儿术后3、6个月时的Child-IXTQ评分均显著高于同组术前(均P<0.05)。结论:两种手术术式治疗儿童基本型间歇性斜视的成功率相当,均能够有效改善患儿立体视功能、多焦视觉诱发电位和生活质量,但单眼一退一截术术后外斜偏移量较双眼外直肌后徙术更大,这可能会造成单眼一退一截术远期疗效降低。Objective:To observe the effects of binocular external rectus recession on visual function,multifocal visual evoked potential and quality of life in children with basic intermittent exotropia.Methods:The clinical data of 84 children with basic intermittent strabismus were retrospectively analyzed.Among them,43 children treated by binocular external rectus recession were included in group A,and 41 children treated by monocular retraction and resection were included in group B.The correction effect of strabismus and postoperative stereoscopic function,far strabismus,near strabismus,exotropia offset and multifocal visual evoked potential were compared between the two groups.The Child-IXTQ was used to evaluate the quality of life of children before surgery and at 3,6 months after surgery.Results:There was no significant difference between the two groups at 1 day,1 month,3 months and 6 months after operation(all P>0.05).Compared with pre-operation,the proportion of children without stereopsis decreased significantly at 1 month,3 months and 6 months after operation,and the proportion of central stereopsis increased significantly(all P<0.05).The proportion of no far stereopsis at 3 and 6 months after operation was significantly lower than that before operation and 1 month after operation(all P<0.05).There was no significant difference in near stereopsis acuity and the proportion of no far stereopsis between the two groups at different times(all P>0.05).The 6 m strabismus and 33 cm strabismus at 1 month,3 and 6 months after operation were significantly lower than those at 1 day after operation(all P<0.05).The characteristic peak amplitude response density of the fourth and sixth rings of P-wave centrifugal ring at 6 months after operation was significantly higher than that before operation(all P<0.05),and there was no significant difference in the amplitude response density of other characteristic peaks compared with that before operation(all P>0.05).The amount of exotropic drift in group A at 3 and 6 months after operat

关 键 词：基本型间歇性斜视 治疗 双眼外直肌后徙术 单眼一退一截术 多焦视觉诱发电位 生活质量 

分 类 号：R779.7[医药卫生—眼科]