新诊断标准下儿童弱视的远期疗效分析

Long term efficacy of comprehensive treatment for children with amblyopia in new standard of diagnosis

目的分析新的诊断标准下,综合疗法治疗弱视的远期疗效及相关因素的影响。方法以2011年弱视诊断专家共识,作为研究的入选标准,对72例（116眼）弱视儿童按年龄,弱视类型及程度分类,进行综合疗法治疗,随访5年,对比分析其疗效及其相关因素。结果在72例（116眼）弱视儿童中,5年综合治疗后,总有效率为90.5%,总痊愈率为72.4%。其中屈光不正性弱视的基本痊愈率为97.8%,与屈光参差性弱视（57.1%）和斜视性弱视（54.3%）组间差异有显著性（P〈0.05）。轻度弱视的基本痊愈率为98%,与中度弱视（68.9%）和重度弱视（15%）相比,组间差异有显著性（P〈0.05）。4-7岁组基本痊愈率（88.2%）与8-14岁组（42.5%）相比,差异有显著性（P〈0.05）。结论儿童弱视的疗效与治疗的时间、弱视类型、程度、年龄等因素有关。其痊愈率也可能受其入选标准影响。

Objective In new standard of diagnosis, to investigate the long term efficacy of comprehensive treatment for amblyopia in children and the effect factors.Methods According to the expert consensus of amlbyopia diagnosis in 2011, totally 72 cases （116 eyes） were classified by the type of amblyopia, degree of amblyopia, and age, treated with correction of refractive error,occlusion therapy, family fine eyesight training and red light therapy, comprehensive therapeutic apparatus, and followed up 5 years.Results Follow up 5 year,the total effective rate is 90.5% , the total cure rate is 72.4%.Ametropic amblyopia （ 97.8%） was significantly higher than the anisometropic（57.1%）, strabismic amblyopia（54.3%） in the cure rate.Mild amblyopia（98%） was significantly higher than the moderate（68.9%） and severe amblyopia（15%） in the cure rate.The younger treatment of amblyopia, the better efficacy.The 4 to 7-year-old group （ 88.2 %） was significantly higher than 8 to 14-year-old group（42.5 %） .Conclusions Amblyopia treatment efficacy is closely related to type of amblyopia, degree of amblyopia, age of starting treatment, the duration of treatment, and it may be influenced by the standard of the diagnosis.