急性共同性内斜视儿童早期应用A型肉毒素注射治疗的临床观察  

Clinical observation of botulinum toxin type A in the treatment of acute concomitant esotropia in early childhood

作　　者：秦素英[1] 慕同禄[2] 李翯[1] 申蕾[1] 牛壮 朱华伟[2] Qin Su-Ying;Mu Tong-Lu;Li He(Department of Strabismus and Pediatric Ophthalmology,Anyang Eye Hospital,Anyang 455000,China)

机构地区：[1]河南省安阳市眼科医院斜视与小儿眼科,455000 [2]濮阳市安阳地区医院神经内科

出　　处：《中国斜视与小儿眼科杂志》2024年第3期33-34,I0009,I0010,共4页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的 观察BTA注射治疗儿童早期ACE的临床疗效。方法 回顾分析2020年5月至2023年12月在我院治疗的儿童ACE59例,根据发病时间不同分为两组,BTA注射组34例(发病时间小于6月),手术组25例(发病时间大于6月)。随访观察6月,比较两组患儿术前、术后1周、1月、3月、6月斜视度;术前和术后6月近立体视、术后6月正位率;术后并发症情况。结果 两组患儿术前一般情况比较差异无统计学意义(均P>0.05);BTA注射组术前、术后1周、1月、3月、6月斜视度分别为(36.72±12.67) PD、(-2.10±5.11)PD、(0.71±1.29) PD、(1.94±2.23) PD、(2.84±2.88) PD;手术组术前、术后1周、1月、3月、6月斜视度分别为(37.24±13.85) PD、(2.32±4.71) PD、(2.76±4.75) PD、(2.80±4.43) PD、(3.02±4.01) PD。两组患儿术后不同时间点斜视度均较术前降低,差异有统计学意义(F=95.786,P<0.001)。两组患儿斜视度比较术前、术后3月、6月差异无统计学意义(均P>0.05)。术后6月时,BTA注射组34例患儿均存在近立体视,手术组24例患儿存在近立体视,1例患儿无近立体视。术后两组患儿近立体视较术前均改善(Z=2.087,P=0.042)。两组患儿术前、术后6月近立体视比较差异均无统计学意义(均P>0.05)。术后6月,BTA注射组30例88.24%(30/34)正位,手术组23例92.00%(23/25)正位,两组患儿正位率比较差异无统计学意义(χ^(2)=0.378,P=0.084)。术后1周时,BTA注射组5例患儿(14.71%)出现上睑下垂,4例患儿(11.76%)出现过矫外斜视、内转轻度受限,3月时均自行恢复。结论 A型肉毒素注射治疗发病时间小于6月的早期儿童ACE安全、效果良好,可作为发病早期的治疗方案。Objective To observe the clinical effect of BTA injection in the treatment of ACE in early childhood.Methods 59 cases of acute concomitant esotropia in children treated in our hospital from May 2020 to December 2023 were retrospectively analyzed and divided into BTA injection group(less than 6 months of onset),34 cases and extraocular muscle surgery group(more than 6 months of onset),25 cases according to the different onset time.The two groups were followed up for 6 months,and the degree of strabismus was compared before surgery,1 week after surgery,1 month,3 months and 6 months.Preoperative and 6 months postoperative near stereoscopy,6 months postoperative correction rate;postoperative complications.Results There was no significant difference in preoperative general situation between the two groups(all P>0.05).The strabismus of BTA injection group was(+36.72±12.67)PD,(-2.10±5.11)PD,(+0.71±1.29)PD,(+1.94±2.23)PD,(+2.84±2.88)PD before surgery,1 week after surgery,1 month,3 months,and 6 months,respectively.The strabismus before surgery,1 week after surgery,1 month,3 months and,6 months were(+37.24±13.85)PD,(+2.32±4.71)PD,(+2.76±4.75)PD,(+2.80±4.43)PD and(+3.02±4.01)PD,respectively.The degree of strabismus in the two groups at different time points after surgery was lower than that before surgery,and the difference was statistically significant(F=95.786,P<0.001).There was no significant difference in the degree of strabismus between the two groups before surgery,3 months after surgery and 6 months(all P>0.05).At 6 months after surgery,all 34 patients in the BTA injection group had near stereo vision,24 patients in the extraocular muscle surgery group had near stereo vision,and 1 child did not have near stereo vision.After operation,the near stereoscopic vision in both groups was improved compared with that before operation(Z=2.087,P=0.042).There was no significant difference in near stereoscopic vision between the two groups before surgery and 6 months after surgery(all P>0.05).Six months after surgery,88

关 键 词：A型肉毒素 早期 急性共同性内斜视 疗效 

分 类 号：R777.41[医药卫生—眼科]