先天性白内障患儿术后弱视训练的家庭康复指导

Home Rehabilitation Instruction for Postoperative Amblyopic Training of Child Patients with Congenital Cataract

目的通过对先天性白内障患儿术后家庭康复训练指导,使患儿能够坚持弱视训练,巩固并提高先天性白内障患儿术后视力。方法先天性白内障患儿56例93只眼,在住院期间对患儿及家长有计划地进行心理干预,指导患儿及其家长弱视训练的方法和注意事项,并指导家长亲自操作。在患儿出院时根据患儿的年龄及视力情况制定具体的弱视训练计划和复诊时间,定期给予电话指导及家庭访视并询问训练情况,针对存在的问题及时解决并强化坚持训练的重要性。结果通过家庭康复指导,48例3～12岁患儿共81只患眼,平均训练27个月,其中67%达到良好视力,8例6～36个月患儿12只患眼平均训练18个月,其中58%达到注视反射灵活。结论本组患儿能够坚持弱视训练且经过弱视训练不仅可以使患儿视力有所提高,甚至可以达到正常水平。家庭康复指导是目前能够使患儿坚持弱视训练的有效的方法之一,能够提高患儿的视力和生活质量。

Objective To make child patients with congenital cataract persist in amblyopic training and consolidate and improve their eyesight after operation by postoperative home rehabilitation instructions. Methods 56 child patients with congenital cataract （93 eyes） were chosen. Adequate mental interventions were planed and performed for the patients and their parents. The authors taught the child patients and their parents the training methods and cautions of amblyopic training and guided the parents to operate by themselves. Concrete training program and visit time were formulated according to patients＇ age and their discharge eyesight. Regular call instructions and home visits were made to understand their situations. It was very important to solve the existing problems and intensify the training. Results By the home rehabilitation instruction, 81 eyes of 48 child patients aged from 3 to 12 years old, 67% had good eyesight （twenty-seven months averagely）. Twelve eyes of 8 patients aged from 6 to 36 months, 58% had good fixate ability （18 months average）. Conclusion Patients can insist on the amblyopic training to improve the visual acuity and even to have normal vision. Home rehabilitation instruction is one of the effective methods to make children insist on amblyopic training and elevate their quality of life accordingly.