先天性上斜肌麻痹其下斜肌病变程度的观察

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

目的:测量先天性上斜肌麻痹患者其下斜肌异常的程度。方法:采用临床横断面研究,自身配对对照设计。选取30例合并单眼上斜肌麻痹的外斜视(间歇性外斜视、恒定性外斜视)患者做双眼外直肌后退和下斜肌减弱等相应的垂直肌手术时,观察患者麻痹眼和非麻痹眼的下斜肌,测量下斜肌的紧张度。下斜肌的紧张度是以斜视钩垂直于巩膜勾出下斜肌,肌肉离开巩膜的最大距离表示。结果:麻痹眼的下斜肌粗细不等,但都比健眼下斜肌坚韧、紧绷。麻痹眼的下斜肌平均紧张度为6.33±1.35mm,非麻痹眼的下斜肌平均紧张度为7.76±0.81mm,两者的差异具有统计学意义(P<0.01)。结论:上斜肌麻痹时患眼的下斜肌紧张度较高、弹性较差。

AIM ： To measure the abnormality of the inferior oblique tendon in patients with congenital superior oblique muscle paralysis. METHODS： In this cross - sectional, self - control designed study, the tensity of the inferior oblique tendon of both the paralytic and nonparalytic eye were measured during the operations in 30 patients who were diagnosed with exotropia （including intermittent exotropia and constant exotropia ） accompanied with single superior oblique muscle paralysis. The tensity of the tendon was measured as the maximal distance of which the inferior oblique tendon could be lifted from the sclera ~ RESULTS： Inferior oblique had different degrees of thickness, but was tougher and tighter than that of nonparalytic eye. There was a significant difference （P〈 0.01 ） in the average tensity of the inferior oblique tendon between the paralytic eyes 6. 33 ＋ 1. 35ram and the nonparalytic eyes 7.76-＋0.81 mm.~ CONCLUSION： The inferior oblique tendon is stronger and less relaxant in the paralytic eyes.