阿托品治疗单眼弱视的临床研究

Clinical research of atropine for treatment of monocular amblyopia

目的 探讨阿托品联合短时遮盖治疗单眼弱视的临床疗效.方法 将120例单眼弱视患儿完全随机分为遮盖组（62例）和阿托品组（58例）.遮盖组患儿遮盖弱视眼每天不少于8h；阿托品组患儿优势眼每日滴1％阿托品眼膏1次,连续用药10 d,停药15 d,并每日遮盖优势眼3～4h.随访20～36个月,并比较2组的依从性、有效率.结果 遮盖组患儿依从性逐渐下降,18个月内有9例放弃治疗,1例失访；阿托品组无一例放弃治疗；阿托品组患儿依从性明显好于遮盖组（P＜0.05）.治疗6、12、18个月时阿托品组有效率分别为72.4％ （42/58）、84.5％ （49/58）、87.9％ （51/58）,均明显高于遮盖组[35.5％ （22/62）、45.2％（28/62）、51.6％ （32/62）],差异有统计学意义（均P＜0.01）.结论 阿托品联合短时遮盖有利于提高单眼弱视患儿治疗依从性,提高治愈率.

Objective To evaluate the therapeutic effect of atropine combined with short-time occlusion for treatment of monocular amblyopia. Methods All 120 patients with monocular amblyopia were randomly divided into occlusion group（62 cases） and atropine group （58 cases）. The children in occlusion group were covered superior eye more than 8 hours a day, while the children in atropine group were covered superior eye for 3 to 4 hours a day, at the same time the superior eye was dropped atropine eye ointment once a day for 10 days a month. All cases were observed for 20 to 36 months, and compliance of patients and effective rate were analyzed and compared. Results Compliance gradually decreased in occlusion group, and there were 10 cases withdrew from treatment. In atroping group without a case abandoning treatment. The compliance in atroping group was better than that in occlusion group （ P 〈 0. 05 ）. For 6 months, 12 months and 18 months of treatment the effective rates in atroping group were 72.4% （42/58） , 84. 5 % （ 49/58 ） , 87.9% （ 51/58 ） respectively, which were significantly higher than those in occlusion group[35.5% （22/62） ,45.2% （28/62） ,51.6% （32/62） 1 （ all P 〈 0. 01 ）. Conclusions Atropine penalization and patching are both effective methods in treating amblyopia. Atropine combined with short-time occlusion for treatment of monocular amblyopia can improve the treatment compliance and increase the cure rate.