先天性上斜肌麻痹上斜肌肌腱病变程度的观察

Clinical observation of the abnormality of superior oblique tendon in congenital superior oblique muscle paralytic patients

目的:测量先天性上斜肌麻痹患者的上斜肌肌腱异常的程度。方法:采用临床横断面研究,自身配对对照设计。在给22例合并单眼上斜肌麻痹的内斜视(先天性内斜视、基本型内斜视、部分调节性内斜视)患者做双眼内直肌后退和上斜肌折叠等相应的垂直肌手术时,测量了患者的麻痹眼和非麻痹眼的上斜肌肌腱宽度和上斜肌肌腱紧张度。上斜肌紧张度用斜视钩垂直勾出前段上斜肌肌腱,肌腱离开巩膜的最大距离代表。结果:麻痹眼的上斜肌肌腱平均宽度为2.64±0.69mm,非麻痹眼的上斜肌肌腱平均宽度为3.84±0.56mm,两者的差异具有统计学意义(P<0.01);麻痹眼的上斜肌肌腱平均紧张度为9.02±1.68mm,非麻痹眼的上斜肌肌腱平均紧张度为6.48±1.33mm,两者的差异具有统计学意义(P<0.01)。结论:上斜肌麻痹时上斜肌肌腱相对较细、较松弛。

AIM：To measure the abnormality of the superior oblique tendon in patients with congenital superior oblique muscle paralysis.METHODS：This is a cross-sectional,self-control designed study.The width and the tensity of the superior oblique tendon of both the paralytic and nonparalytic eye were measured during the operations in 22 patients who were diagnosed with esotropia（including congenital esotropia,basic esotropia and partially accommodative esotropia） accompanied with single superior oblique muscle paralysis.The tensity of the tendon was measured as the maximal distance of which the superior oblique tendon could be lifted from the sclera.RESULTS：There was significant difference（P0.01） in the average width of the superior oblique tendon between the paralytic eyes（2.64±0.69mm） and the nonparalytic eyes（3.84±0.56mm）.There was also significant difference（P0.01） in the average tensity between the paralytic eyes（9.02±1.68mm） and the nonparalytic eyes（6.48±1.33mm）.CONCLUSION：The superior oblique tendon is narrower and more relaxant in the paralytic eyes.