后天性麻痹性斜视3例分析  

Case Report of Three Cases of Acquired Paralytic Strabismus

作　　者：黄丹[1] 刘琛 邓燕[1] HUANG Dan;LIU Chen;DENG Yan(Department of Ophthalmology,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院眼科,南昌330006

出　　处：《实用临床医学（江西）》2024年第1期66-69,F0004,共5页Practical Clinical Medicine

摘　　要：目的探讨后天性麻痹性斜视特异性病因及处理方法。方法回顾性分析3例后天性麻痹性斜视患者的临床资料。结果3例患者为儿童,均突然起病,表现为明显的眼球运动障碍,诊断为麻痹性斜视,发病原因及全身伴随症状各异。其中,间叶来源恶性肿瘤患儿对症治疗后,症状明显好转,右眼眼位正位,轻度外转受限,无复视;中耳炎患儿抗感染治疗17 d后,右眼正位,外转无明显受限,无复视;重症肌无力患儿对症治疗后,症状明显改善,双眼睑基本无下垂,左眼下转稍受限,外转正常。结论后天性麻痹性斜视病因复杂且病情多变,可伴有全身或神经系统异常。某些疾病表现为眼外肌麻痹常首诊为麻痹性斜视,明确病因有助于临床制定正确的治疗方案。Objective To explore the specific etiology and management of acquired paralytic strabismus.Methods Clinical data from 3 cases of acquired paralytic strabismus in children were retrospectively analyzed.Results All 3 patients were children who experienced sudden onset of the disease and presented with obvious eye movement disorders;they were diagnosed as paralytic strabismus,with different causes of onset and systemic accompanying symptoms.The child with malignant tumor of mesenchymal origin showed significant improvement in symptoms after targeted treatment,with the right eye in normal position and slight restriction in outward rotation,without diplopia;the patient with otitis media showed normal position of the right eye and no obvious restriction in outward rotation after 17 days of anti-infective treatment,without diplopia;the patient with myasthenia gravis showed significant improvement in symptoms after symptomatic treatment,with minimal ptosis in both eyelids,slight restriction in downward rotation of the left eye,and normal outward rotation.Conclusion The causes of acquired paralytic strabismus are complex and variable,and may be accompanied by systemic or neurological abnormalities.Certain diseases presenting with paralysis of extraocular muscles are often first diagnosed as paralytic strabismus,and identifying the cause may be helpful in formulating appropriate clinical treatment plan.

关 键 词：麻痹性斜视 后天性 恶性肿瘤 中耳炎 重症肌无力 儿童 病例报告 

分 类 号：R777.41[医药卫生—眼科]