摘要
目的探讨上斜肌麻痹(Superiorobliquepalsy,SOP)的发病情况、分类、临床表现、常用检查方法的应用价值及手术选择的基本原则。方法系统回顾性分析1987～2001年收治的355例SOP患者。结果在601例各类麻痹性斜视的患者中355例(59.1%)为SOP。先天性和后天性分别为293例(82.5%)和62例(17.5%)。双侧病变90例(25.4%)。319例(89.9%)归属于Knapp分类标准。先天性和后天性病例(例/例,%)中分别为:代偿头位160/293(54.6),47/62(75.8),P<0.01;合并水平斜视190/293(64.8),20/62(32.3),P<0.001;检查弱视110/209(52.6),0/62;检查同时视114/202(56.4),23/23(100.0),P<0.001;检查融合66/157(42.0),20/20(100.0),P<0.001;检查远立体视41/148(27.7),13/18(72.2),P<0.001;检查近立体视19/146(13.0),3/16(18.8),P>0.05。92.8%先天性SOP眼有下斜肌亢进。82.5%后天性SOP者有明显自觉复视。自觉外旋斜视检出率为46.2%。同视机检查者中89.3%可获得有价值的诊断、评估结果。51例有明显复视的后天性SOP经红绿眼镜复视试验均可确诊。结论SOP在各类麻痹性斜视中最多见,绝大多数符合Knapp分类标准,双侧(尤以先天性)麻痹较多;先天性SOP比后天性SOP双眼视功能损害严重,但两者近立体视均严重受损;同视机检查对SOP的诊断、评估最有价值。
Objective To explore the prevalence,classification,clinical manifestations of superior oblique paralysis(SOP),to evaluate the applied value of several examination methods generally used and to describe the general surgical guidelines in a large number of the patients.Methods Clinical data of355patients with SOP who were examined and treated during the past14years were retrospectivelly and systematically analysed.Results Among the601patients with various paralytic strabismus,355(59.1%)patients suffered from SOP and319(89.9%)patients belonged to7classes proposed by Knapp and Moore.Of the355patients,293(82.5%)had a congenital onset,62(17.5%)had an acquired onset and90(25.4%)had a bilateral involvement.The presentations and the results of several examinations in the patients with congenital SOP and acquired SOP were respectively as follows:compensatory head posture:160/293(54.6%),47/62(75.8%),P<0.01;horizontal strabismus accompanying SOP:190/293(64.8%),20/62(32.3%),P<0.001;amblyopia:110/209(52.6%),0/62,P<0.001;simultaneous perception:114/202(56.4%),23/23(100.0%),P<0.001;fusion:66/157(42.0%),20/20(100.0%),P<0.001;distance stereoacuity:41/148(27.7%),13/18(72.2%),P<0.001;near stereoacuity:19/146(13.0%),3/16(18.8%),P>0.05.Inferior oblique overaction occurred in92.8%of the eyes in the patients with congenital SOP.The82.5%of patients with acquired SOP were accompanied with diplopia.Subjective extorsion strabismus was found in46.2%(91/197)of the patients.Valuable results were obtained in89.3%of the patients who were examined with synoptophore,51patients with acquired SOP who accompanied with diplopia were definitively diagnosed by diplopia test with red and green glasses.Conclusion SOP is the most common form of paralytic strabismus and bilateral involvement is frequent.The patients with congenital SOP have a more impaired binocular vision than the patients with acquired SOP,but both groups of the patients have a severely impaired near stereoacuity.Synoptophore examination is the most valuable method for diagnosing and
出处
《实用医药杂志》
2002年第12期897-899,共3页
Practical Journal of Medicine & Pharmacy
关键词
眼外肌麻痹
麻痹性斜视
上斜肌麻痹
斜视
External ophthalmoplegia Paralytic strabismus Superior oblique paralysis Strabismus
