手术治疗Duane眼球后退综合征的临床分析

A Surgical Treatment Analysis of Duane's Retraction Syndrome

探讨Duane眼球后退综合征（DRS）的临床特征,鉴别诊断以及手术治疗的方法和效果。对自2003年~2010年16例因DRS行手术治疗的患者资料进行回顾性总结和分析,观察项目包括患者的性别和年龄、DRS类型和临床表现、手术治疗方式和效果。16例患者中,男7例,女9例。左眼受累11例,右眼受累5例,左眼易患病。I型10例;Ⅱ型2例;Ⅲ型4例。12例患者合并内转眼急速上转和（或）下转现象,多为DRS外斜视者。全部16例患者均行单眼内直肌和（或）外直肌后徙术或双眼内直肌后徙术,其中有2例行上直肌后徙术,4例行下斜肌切断术,术后均取得满意效果。典型的DRS诊断并不困难,不同类型DRS的临床表现不同,内转眼上、下转现象多见于DRS外斜视者,详细的术前检查和合理的手术方案设计对眼球后退综合征的治疗具有重要意义。

To analyze the clinical manifestations,differential diagnosis and the methods and effects of surgical management on Duane＇s Retraction Syndrome（DRS）,16 cases with DRS in 2003-2010 were summarized retrospectively.The data were recorded and analyzed,including sex,age,type,clinical features,surgical methods and the results.There were 7 males and 9 females,11cases had left eye involvement,5cases had right eye involvement.The number of Type I DRS was 10 cases.2 cases were Type ⅡDRS and 4 cases were Type III DRS.In12 cases with upshoot and/or downshoot phenomenon,most of them were associated with exotropia.All the patients underwent ipsilateral medial rectus or lateral rectus recession,or bilateral medial rectus recession,2 patients were treated by recession of superior rectus muscle,and 4 patients were treated by myectomy of the inferior oblique muscle.All patients have better surgical effect.Different type had different clinical features,diagnosis of DRS in a typical case is not difficult,Th e careful and complete examination before surgery is important for treatment of DRS.