麻痹性斜视183例临床分析

Clinical analysis of 183 cases with paralytic strabismus

目的:探讨近年来麻痹性斜视的病因、麻痹肌分布和对视功能的影响。方法:对我院2009-03/2012-03住院行斜视矫正术的183例麻痹性斜视患者的病历资料进行回顾性研究。结果:先天性麻痹性斜视占80.87%,后天性麻痹性斜视占19.13%;原因不明者最多(77.60%),其次为外伤(14.21%)。垂直斜视中上斜肌麻痹占81.19%,下直肌麻痹占8.26%,上直肌麻痹占6.88%,下斜肌麻痹占2.29%,双上转肌麻痹占0.92%,双下转肌麻痹占0.46%。水平斜视中外直肌麻痹占54.17%,内直肌麻痹占45.83%。166例患者术前进行同视机检查,有双眼视功能患者占28.92%。结论:麻痹性斜视病因复杂,眼外肌中上斜肌最常累及,对双眼视功能有明显的影响,应尽早进行手术治疗。

AIM： To investigate pathogeny of paralytic strabismus, the patterns of paralytic extraocular muscles and effects of paralytic strabismus on binocular vision. METHODS： A retrospective study was done in 183 patients with paralytic strabismus who underwent squint correction in our hospital from March 2009 to March 2012. RESULTS： Of the 183 patients reviewed, the incidence of congenital paralytic strabismus was 80.87%, acquired paralytic strabismus accounted for 19.13%. In 77.60% of the cases, the causes could not be identified, followed by trauma accounted for 14. 21%. Among all vertical strabismus the ratio of superior oblique palsy, inferior rectus palsy, superior rectus palsy, double elevator palsy, inferior oblique palsy, double depression palsy accounted for 81. 19%, 8. 26%, 6. 88%, 2. 29%, 0. 92%, 0. 46%, respectively. Among all horizontal strabismus the rate of extra rectus palsy was 54. 17%, internal rectus palsy 45.83%. 28. 92% of patients who were examined with synoptophore had binocular function. CONCLUSION： Paralytic strabismus had complex causes. The most common paralytic extraocular muscle was superior oblique muscle. It has important effects on binocular vision. Therefore, surgical treatment should be carried out as early as possible.