成人斜视术后生活质量评估

Improved quality of life in patients following strabismus surgery

目的 评估斜视手术对成人斜视患者生活质量的影响.方法 前瞻性研究.对2013年11月至2014年9月在四川大学华西医院眼科就诊的89例成人斜视患者,分别在其术前1d及术后（83.6±34.0）d采用成人斜视生存质量量表（AS-20）进行生活质量评价.分析手术前后AS-20分值的变化情况,并评估年龄、性别、斜视类型、双眼视觉和手术前后AS-20分值及其变化值的关系.对数据进行独立样本t检验,秩和检验和Spearman相关分析.结果 患者术前AS-20得分为（50.3±18.5）分,术后得分为（80.8±20.6）分,差异有统计学意义（t=9.975,P＜0.01）.相比男性,女性在术前的AS-20得分偏低,在术后提升快,差异均有统计学意义（t术前=2.050,t变化=-2.593,P＜0.05）;而无论术前术后,不同斜视类型（t术前=-0.480,t术后=0.237,t变化=1.495,P＞0.05）、双眼视觉是否为阳性（t术前=0.446,t术后=0.498,P＞0.05）患者间的AS-20得分差异均无统计学意义,患者年龄与手术前后AS-20总分值的差值无相关性（r=0.021,P＞0.05）.结论 成人斜视患者术后生活质量有明显提高.女性相比男性在术前的生活质量偏低,在术后提升快.内外斜视患者、是否存在双眼视觉患者及不同年龄患者的生活质量改善情况并无明显差异.

Objective To evaluate the effect of strabismus surgery on the quality of life in strabismus patients.Methods From November 2013 to September 2014,89 strabismus patients at West China Hospital were evaluated with an Adult Strabismus （AS-20） test and were followed up for （83.6±34.0）days.The difference between pre-and postoperative scores was analyzed using the AS-20 test and its subscales （psychosocial and functional）.The influence of age,gender,deviation type,and the existence or non-existence of binocular vision were compared using independent samples t test,rank sum test,Spearman test.Results The preoperative AS-20 total score was 50.3±18.5 and was significantly higher at 80.8±20.6 postoperatively （t=9.975,P〈0.01）.Females had a lower preoperative AS-20 total score but had greater improvement compared to males （tpy=2.050,tchange=-2.593,P〈0.05）.Patients with esotropia and exotropia （tpre=-0.480,tpost,=0.237,tchange=1.495,P〉0.05） and the existence of binocular vision （tpre=0.446,tpost=0.498,P〉0.05） did not show a statistically significant difference in the AS-20 total scores or a change in AS-20 scores.There was no correlation between age and the change in AS-20 scores （r=0.021,P〉0.05）.Conclusion Strabismus surgery resulted in a highly significant improvement in quality-of-life scores.Females had a lower quality-of-life preoperatively but had a greater benefit.There was no relationship between the deviation type,age,or the existence or non-existence of binocular vision and the AS-20 scores.