后天麻痹性斜视41例病因分析

Etiological analysis of 41 cases with acquired paralytic strabismus

目的探讨后天麻痹性斜视的年龄、性别分布特点及常见病因。方法对41例(43只眼)复视患者采用角膜映光法、同视机及红玻璃片等方法检查眼位、眼球运动及复视像,辅以血液生化、甲状腺功能,CT、MRI等影像学检查,分析后天麻痹性斜视常见病因及年龄、性别分布情况。结果 41例(43只眼)中50岁以上占75.6%,50岁以下占24.4%;男:女=32:9;病因中血管性疾病占36.58%,糖尿病占26.83%,眼外伤占9.75%,颅脑外伤、肿瘤分别占7.32%,重症肌无力、Graves眼病分别占4.88%,获得性免疫缺陷综合征(AIDS)占2.44%;50岁以上病因以血管性疾病和糖尿病居多,50岁以下以眼外伤、颅脑外伤居多。结论后天麻痹性斜视病因复杂,应对患者进行全面的检查。

Objective To investigate the relationship between age, distribution of sexual distinction and the etio- logical features of acquired paralytic strabismus. Methods Ocular position,muscle movement and diplopia images were ob- served with corneal light reflection test synoptophore and red glass test,and examined with imaging diagnosis （ CT, MRI, ultrasonography ）, thyroid function and biochemical examination of Mood in 41 cases. Results Among 41 eases, the propor- tion over the 50 years old was 75.6% and 50 years old the following account for 24.4% ;male：female = 32：9. The main causes are vascular diseases （ 36.58% ）, diabetes （ 23.83% ）, orbital trauma （ 9.75% ）, graniocerebral trauma （ 7. 32% ）, tumor（7.32% ） ,myasthenia gravis （4.88% ） ,thyroid ophthalmopathy （4. 88% ） ,AIDS（ 2. 44% ）. Vascular diseases and diabetes are common in the cases over 50 years old. Orbital trauma and graniocerebral trauma are common in the eases less 50 years old. Conclusion The causes of acquired paralytic strabismus are complicated and a completed examination is nee- ded.