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直肌边缘切开联合楔形切除治疗儿童共同性斜视的远期疗效观察 被引量:5

Long-term Clinical Observation on the Effect of Rectus Marginal Myotomy with Wedge Excision in children with Concomitant Strabismus.
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摘要 目的探讨儿童直肌边缘切开联合楔形切除治疗共同性斜视的远期临床效果。方法回顾性分析477例共同性斜视患者,其中儿童组(年龄≤15岁)247例,成人组(年龄〉15岁)230例。对儿童组和成人组以及儿童组中不同斜视度的治疗效果进行了对比分析,随访时间12个月至5年。结果儿童组和成人组手术时间为(9.47±1.35)min、(10.42±1.54)min,术后12个月的正位率分别为76.9%、83.9%;术后12个月的残斜视度分别为(15.45±3.52)^△、(8.24±3.10)^△。两组比较,手术时间差异有统计学意义(P〈0.01)。两组相比,获得双眼单视功能的,儿童组所占比例为59.1%,成人组仅为43.5%,差异有统计学意义(P〈0.01)。建立立体视觉的,儿童组所占比例为32.8%,成人组仅为18.7%,差异也有统计学意义(P〈0.01)。当内外斜视度数小于20度(35^△)、介于20度(35^△)与30度(53^△)之间、高于30度(53△)时,双眼直肌边缘切开的一次手术成功率分别为94.1%、84.7%、12.0%。结论儿童直肌边缘切开联合楔形切除治疗共同性斜视是一种安全、远期疗效好的方法。儿童组在正位率方面略低于成人组,但在双眼单视功能和立体视觉方面儿童组优于成人组。儿童组中随着斜视度数的增高,双眼直肌边缘切开的一次手术成功率逐渐下降。当斜视度数高于30°(53^△)时需联合其他肌肉手术。 Objective To discuse the clinical outcome of rectus marginal myotomy and wedge excision in children with concomitant strabismusMethods The retrospective study was used on 477 patients with concomitant strabismus. The patients were divided into the children group and the adults group.There are 247 patients were involved in children group and 230 patients were involved in adults group. The treatment results were compared between these two groups and the patients were followed up from 12 months to 5 years after operation. Results The operation time of group 1 and group 2 were 9.47 ± 1.35 minutes and 10.42 ± 1.54 minutes respectively. The 12 months effective ratios of these two groups were 76.9% and 83.9% respectively. The post-operative residual degrees were (15.45 ± 3.52)A and(8.24 ± 3.10)A respectively. The difference of operation time between these two groups was statistically significance (P 〈 0.05).The difference of Long-term effective ratio and post-operative residual degrees were both statistically significance (P〈0.01).The single binocular vision was got in 59.1% of patients in children group and in 43.5% of patients in adults group. The stereopsis was got in 32.8% of patients in children group and in 18.7% of patients in adults group. There were statistically significant difference between these two groups (P 〈 0.01). The patients were subsequently divided into three groups according to the different degrees in children group: less then 35^△,35^△ _ 53^△ ,and higher than 53^△. The effective ratio of bilateral marginal myotomy were 94.1%, 84.7% and 12.0% respectively. Conclusions Rectus marginal myotomy and wedge excision was found to be a safe and good long-term postoperative effect method in children with concomitant strabismus.The effective ratio of children group is lower than that of adults group. As to the single binocular vision and stereopsis, children group are better than that of adults group. Effective ratio of primary operation tends to decrease in higher de
出处 《中国实用眼科杂志》 CSCD 北大核心 2007年第12期1307-1310,共4页 Chinese Journal of Practical Ophthalmology
关键词 直肌边缘切开联合楔形切除 共同性斜视 儿童 临床效果 rectus marginal myotomy and wedge excision concomitant strabismus children clinical outcome
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