医院及家庭联合治疗大龄儿童弱视的效果观察

Clinical observation of hospital therapy combined with family care in the treatment of amblyopia in the elder children

目的探讨医院及家庭联合治疗大龄儿童弱视的临床效果。方法选择7～15岁的大龄儿童73例(113眼),采用医院及家庭联合实施弱视综合疗法对患儿进行治疗,并对临床资料进行总结、分析。结果113眼中有96眼有效,总有效率84.96%,其中基本痊愈61眼(53.98%)、进步35眼(30.97%)、无效17眼(15.93%)。17例无效眼中,屈光度超过±10.00 D者6眼、斜视伴双眼无同视功能5眼、眼颤者1眼、散光超过4.00 D者2眼、家庭不配合未坚持治疗者3眼。轻、中度弱视的疗效优于重度弱视;中心注视的疗效优于旁中心注视。结论医院及家庭联合治疗大龄儿童弱视能取得满意疗效,需要医务人员、家属和儿童的共同配合。只有充分调动弱视患儿成长环境中关系密切的群体力量,才能提高其治疗效果。因此对大龄儿童的弱视治疗,除科学、系统及规范的治疗外,还应积极地提高家庭支持度。

Objective To evaluate the clinical effects of hospital therapy combined with family care in the treatment of amblyopia in the elder children. Methods Seventy-three elder children（ 113 eyes） aged from 7 to 15 years with amblyopia were selected and treated with the hospital therapy combined with family care. The clinical data were retrospectively analyzed. Results Among the 113 eyes, 96 eyes turned out to be effective, the total effective rate being 84.96%. Sixty-one eyes（53.98% ） were cured, 35 eyes （30.97%） got better and 17 eyes （15.93%） turned out to be ineffective. Among the 17 ineffective eyes ,6 eyes were over ± 10.0 D, 5 eyes were strabismus without simultaneous perception, 1 eye was congenital nystagmus,2 eyes were astigmatism over 4.00 D, 3 eyes were due to uneooperated family care. The mild and the moderate amblyopia group showed better therapeutic effect than the severe group. The central fixation group showed better therapeutic effect than the paracentral fixation group. Conclusions With the cooperation of the medical workers, the family members and the children, hospital therapy combined with family care in the treatment of amblyopia in the elder children could achieve a satisfied effect. Only by sufficient mobilizing of the group factors relative to the growing enviroment of amblyopic children, could we enhance the the therapeutic effect. Therefore, except for the scientific, systematic and normative therapy, it is very important to raise the family supporting degree in the treatment of amblyopia in the elder children.