直肌边缘切开联合楔形切除术治疗斜视的临床观察

Clinical observation of the rectus marginal myotomy with wedge excision on squint

目的 :探讨直肌边缘切开联合楔形切除术治疗斜视的临床效果。方法 :将 12 0例斜视患者随机分为两组 ,一组行肌肉边缘切开联合楔形切除 (实验组 ) ,一组单纯行肌肉边缘切开 (对照组 ) ,随访时间 6个月～ 5年 ,对比两组的临床效果。结果 :实验组和对照组手术时间分别为 10 4± 1 7分钟、 9 6± 1 5分钟 ;术后 6个月的正位率分别为 80 0 %、 60 0 % ;术后 6个月的残存斜视度分别为 4 3± 2 2°、 8 9± 2 1°。两组比较 ,手术时间差异无显著性 (P >0 0 5 ) ;正位率差异有非常显著性 (P <0 0 1) ;残存斜视度差异有非常显著性 (P <0 0 1)。实验组中的术后矫正斜视度数与术中楔形切除的肌肉宽度值呈显著正线性相关性 (γ =0 947,P <0 0 1)。两组的手术并发症相似。结论 :直肌边缘切开联合楔形切除术治疗斜视是一种安全、远期疗效好。

To explore the clinical outcome of rectus marg inal myotomy with wedge excision on the patients with squint. Methods:120 squints were selected and randomly divided int o the trial group and the control group.In the formal both rectus marginal myotomy with wedge excision were run,and in the controls only the rectus marginal myotomy was operated.The clinical outcomes of the two groups were compared with 6 month～5 year follow up. Results:The operative time of trial group and control grou p were 10.4±1.7 minutes and 9.6±1.5 minutes,respectively(P>0.05).The effective rates of the two groups were 80.0% and 60.0%(P<0.01),and the post operative residual degrees were 4.3±2.2°and 8.9±2.1°(P<0.01).Obvious liner relationship existed between the corrected degrees and the muscle width of wedge excision.The complications of the two groups were similar. Conclusions:Rectus marginal myotomy with wedge excision se ems a safe and good method with long term effect for squint.The outcome is better than that of simple rectus marginal myotomy.