不同术式治疗先天性上斜肌麻痹疗效分析

The effect of different surgical approaches for congenital superior oblique palsy

目的 探讨先天性上斜肌麻痹的不同手术方式的治疗效果.方法 根据原在位垂直斜视度和眼外肌的功能状况,对47例先天性上斜肌麻痹患者实施不同的手术方式进行分析.结果 术后随访3～24个月,其中40例（85.1%）眼位为正位,7例（14.9%）眼位较前好转.30例（63.8%）代偿头位消失,8例（17.0%）代偿头位减轻.治愈30例（63.8%）,好转17例（36.2%）,总有效率100%.结论 先天性上斜肌麻痹手术方式的选择按照减弱直接拮抗肌及配偶肌,加强麻痹肌原则进行.根据下斜肌亢进程度和垂直斜视度数选择不同手术方式可达到良好治疗效果.

Objective To investigate the effect of different surgical approaches for congenital superior oblique palsy. Methods According to degree of primary vertical strabismus and eye muscle＇s functional status, 47 cases paralytic strabismus were implemented different surgical methods for analysis. Results The mean follow-up was 3-24 months, 40 cases （85. 1%） eye position as the front view, 7 cases （14.9%） eye position better than the previous, 30 cases （63.8%） head tilt were eliminated, 8 （17%） cases head tilt turned for the better, cured for 30 cases （63.8%）, improved in 17 cases （36.2%）, the total effective rate was 100%. Conclusions Election of surgical methods according to the principles of weakens direct antagonist muscle or spouse muscle,augmentation of palsy muscle. Good clinical effect can be obtained by different surgical methods which are chosen according to degree of inferior oblique hyperfunction and vertical strabismus.