刘彦芳，林　萍

(西安市儿童医院眼科，陕西 西安 710003)



双眼外直肌后徙术治疗儿童间歇性外斜视的临床观察

刘彦芳，林萍

(西安市儿童医院眼科，陕西 西安 710003)

目的观察双眼外直肌后徙术治疗儿童基本型间歇性外斜视的临床效果。方法选择2014年3月1日至2015年3月1日在西安市儿童医院就诊的80例斜视度在-30△至-40△的基本型间歇性外斜视患者作为研究对象。80例患者随机分为试验组和对照组，每组均为40例。对照组行单眼的外直肌后徙联合内直肌缩短术，试验组行双眼外直肌后徙术。术后随访1年，比较两组术后眼位正位率、欠矫率、过矫率，融合功能恢复情况和立体视功能恢复情况。结果试验组术后眼位正位率、欠矫率和过矫率分别为85.0%、12.5%和2.5%，对照组术后眼位正位率、欠矫率和过矫率分别为70%、20.0%和10.0%，试验组均高于对照组，差异均具有统计学意义(χ2值分别为4.507、5.103、4.875，均P<0.05)。手术前试验组有融合功能的患者和有立体视的患者分别占75.0%和35.0%，对照组有融合功能的患者和有立体视的患者分别占67.5%和32.5%，两组相比差异均无统计学意义(χ2值分别为0.55和0.06，均P>0.05)。手术后试验组有融合功能的患者和有立体视的患者分别占100.0%和95.0%，均显著高于对照组(分别为90%和60%)，差异均具有统计学意义(χ2值分别为4.21和11.25，均P<0.05)。结论对于基本型间歇性外斜视的儿童实施双眼外直肌后徙术的治疗方式，能够有效的提高治疗效果、改善患者的视觉效果。

双眼外直肌后徙术；儿童；间歇性外斜视；基本型

[Abstract]Objective To observe the clinical effect of binocular lateral rectus recession on the treatment of children basic intermittent exotropia. Methods From March 1 in 2014 March 1 in 2015, totally 80 children with basic intermittent exotropia, the degree of strabismus between -30△to -40△, were selected from Children’s Hospital of Xi’an as research objects. They were randomly divided into experiment group and control group equally. The experiment group was treated by bilateral lateral recession, while the control group was treated by unilateral lateral rectus recession-medial rectus recession. Two groups were followed up for 1 year, and eye position correction effect, under correction rate, over correction rate, fusion function and stereoscopic function recovery were compared between two groups. Results In the experiment group eye position correction rate, under correction rate and over correction rate was 85.0%, 12.5% and 2.5%, respectively. They were 70.0%, 20.0% and 10.0%, respectively, in the control group. The experiment group had higher value than the control group, and the differences were statistically significant (χ2value was 4.507, 5.103 and 4.875, respectively, allP<0.05). Before surgery, there were 75.0% and 35.0% cases with fusion function and stereopsis in the experiment group, and there were 67.5% and 32.5% in the control group. The differences were not statistically significant (χ2value was 0.55 and 0.06, respectively, bothP>0.05). After surgery, patients with fusion function and stereopsis occupied 100.0% and 95.0% in the experiment group, and they were higher than those (90% and 60%) in the control group with statistical significance (χ2value was 4.21 and 11.25, respectively, bothP<0.05). Conclusion Binocular lateral rectus recession on the treatment of children basic intermittent exotropia can effectively improve therapeutic effect of treatment and improve patient’s vision.

[Key words]binocular lateral rectus recession; children; intermittent exotropia; basic type

间歇性外斜视是一种介于外隐斜和共同性外斜视之间的情况，临床上很常见，其中基本型间歇性外斜视是间歇性外斜视的一种常见类型，它的特点是看近斜视角与看远斜视角基本相等。儿童间歇性外斜视，一般在儿童3岁之后开始出现，但是真正的就诊时间却较晚[1-2]。儿童间歇性外斜视的病因，例如先天性眼外肌发育异常或眼球发育异常等[3]。……