视知觉感知训练联合全营养餐序贯疗法治疗学龄前儿童近视性弱视的效果评价

Effect of visual perception training combined with total nutrition meal sequential therapy on myopic amblyopia in preschool children

目的:观察视知觉感知训练联合全营养餐序贯疗法治疗近视性弱视患儿的治疗效果。方法:将本院收治的73例135眼近视性弱视患儿按照随机数字表法分为对照组(36例67眼)和治疗组(37例68眼)。对照组采用传统的带镜遮盖联合精细目力和光栅训练进行治疗;治疗组采用视知觉感知训练联合全营养餐序贯疗法进行治疗。比较两组患儿治疗前和治疗3、6mo,1a的视力、屈光度及年均屈光度变化值;比较两组患儿治疗1a的疗效,并对两组患儿治疗期间的不良反应发生情况进行记录;比较两组患儿中基本治愈的患儿随访1a期间弱视的复发率。结果:治疗3mo,两组患儿的BCVA比较,差异无统计学意义(P>0.05);治疗6mo,1a,治疗组的BCVA均显著优于对照组,差异均有统计学意义(P<0.05)。两组治疗3、6mo,1a后的屈光度均无显著差异(P>0.05),但治疗组的年均屈光度变化值显著低于对照组(P<0.05)。治疗组的基本治愈率和总有效率均显著高于对照组(P<0.05)。两组患儿在治疗期间均无严重不良反应的发生。随访1a,治疗组基本治愈患儿的弱视复发率显著低于对照组(P<0.05)。结论:视知觉感知训练联合全营养餐序贯疗法治疗近视性弱视能显著改善视力,降低年均屈光度变化值,提升患儿的治疗效果,降低弱视复发率。

AIM： To observe the therapeutic effect of visual perception training combined with total nutrition meal sequential therapy in the treatment of myopic amblyopia. METHODS： Totally 73 children（135 eyes）with myopic amblyopia were divided into control group（36 cases, 67 eyes）and treatment group（37 cases, 68 eyes）according to random number table. The control group were treated with traditional spectaculars and grating covering combined with fine eyesight training; the treatment group were treated with visual perception training combined with total nutrient meal sequential therapy. The visual acuity, diopter and average diopter of two groups were compared before and after treatment at 3, 6mo and 1a. The curative effect of two groups of children was compared after 1a treatment. And the adverse reactions were recorded in two groups during the treatment period. The recurrence rate of amblyopia in 1a follow-up was compared between two groups. RESULTS： The difference of visual acuity between two groups was not significant at 3mo（P〉0.05）. The visual acuity of the treatment group was significantly higher than that of the control group at 6mo and 1a（P〈0.05）. There was no significant difference in diopter between the two groups after 3, 6mo and 1a（P〉0.05）, but the average annual refractive changes in the treatment group were significantly lower than that in the control group（P〈0.05）. The basic cure rate and total effective rate of the treatment group were significantly higher than that of the control group（P〈0.05）. There were no severe adverse reactions occurred between two groups during the treatment period. The recurrence rate of amblyopia in the treatment group was significantly lower than that in the control group（P〈0.05）after 1a follow-up.CONCLUSION： Visual perception training combined with total nutrition meal sequential therapy in the treatment of myopic amblyopia in preschool children can significantly improve patients＇ visual acuity, reduce the average annual diopter changes, improve the therapeutic effect, reduce the recurrence rate of amblyopia.