儿童弱视综合治疗87例临床疗效观察

The clinical efficacy of comprehensive therapy in 87 children with amblyopia

目的 探讨综合治疗儿童弱视的疗效.方法 对87例（137眼）弱视儿童阿托品散瞳验光配镜,根据矫正视力情况采用戴镜、遮盖、红光刺激和精细目力训练等综合疗法对其进行治疗.按弱视类型分：屈光不正组96眼、屈光参差组28眼、斜视组13眼.按弱视程度分：轻度组61眼、中度组60眼、重度组16眼.按开始治疗年龄分：3 ～6岁组95眼、7～9岁组25眼、10～ 12岁组17眼.按注视性质分：中心注视组93眼、旁中心注视组44眼.结果 基本治愈87眼（63.50％,87/137）,进步40眼（29.20％,40/137）,无效10眼（7.30％,10/137）,总有效率92.70％（127/137）.弱视治疗效果与弱视类型、弱视程度、开始治疗年龄及注视性质密切相关.屈光参差组疗效优于屈光不正组,轻、中度组优于重度组,中心注视组优于旁中心注视组,年龄越小,治疗效果越好,各组间差异均有统计学意义（P＜ 0.01）.结论 采用综合疗法治疗儿童弱视,可以取得较满意的疗效.

Objective To discuss the clinical efficacy of comprehensive therapy in children with amblyopia.Methods A total of 137 eyes of 87 children were observed.They were given glasses,cover,fine training on the basics of their corrected visual acuity after mydriasis with atropine and optometry.According to amblyopic type,all subjects were divided into three groups,ametropic amblyopia group （96 eyes）,anisometropic amblyopia group （28 eyes） and strabismic amblyopia group（13 eyes）.According to treatment-starting age,they were divided into 3-6 years old group （95 eyes）,7-9 years old group （25 eyes）,and 10-12 years old group （17 eyes）.According to amblyopic degree,they were divided into mild group（61 eyes）,medium group （60 eyes） and serious group （16 eyes）.According to fixation nature,they were divided into central fixation group （93 eyes）,paracentral fixation group （44 eyes）.Results All of subjects＆#39; eyes,87 eyes （63.50%,87/137） were basically cured,40 eyes （29.20%,40/137） were improved,and 10 eyes （7.30%,10/137） were unimproved.The total effect rate was 92.70% （127/137）.The efficacy of treatment was closely related to amblyopic type,treatment-starting age,amblyopic degree and fixation nature.Efficacy of the treatment on anisometropic amblyopia was the highest among all three types.The younger the treatment-starting age,the better the efficacy of the treatment.There was a positive correlation between the mildness of amblyopia and the efficacy of the treatment.Efficacy of central fixation group was better than that of paracentral fixation group.Differences between efficacies of treatment on each group were significant （P 〈 0.01）.Conclusion Comprehensive therapy in children with amblyopia can achieve satisfactory effects.