水平肌加强减弱术联合下斜肌减弱术治疗儿童斜视的效果

Effect of horizontal muscle strengthening and weakening combined with inferior oblique muscle weakening in treatment of children with strabismus

目的探讨水平肌加强减弱术与下斜肌减弱术联合治疗儿童斜视的临床效果。方法回顾性分析2018年1月~2019年1月江西省高安市人民医院收治的儿童斜视60例,患眼92只,按治疗方式分为对照组(30例接受水平肌加强减弱术,患眼42只)和研究组(30例接受水平肌加强减弱术联合下斜肌减弱术,患眼50只)。比较两组的治疗总有效率、斜视度数、术中出血量、恢复治疗时间、视力恢复时间及并发症发生情况。结果研究组的治疗总有效率为93.33%,高于对照组的70.00%,差异有统计学意义(P<0.05);治疗前,两组的斜视度数比较,差异无统计学意义(P>0.05),研究组术后1、3、6个月的斜视度数低于对照组,差异有统计学意义(P<0.05);两组的手术时间比较,差异无统计学意义(P>0.05);研究组的术中出血量少于对照组,差异有统计学意义(P<0.05),研究组恢复治疗时间、视力恢复时间短于对照组,差异有统计学意义(P<0.05);两组的并发症总发生率比较,差异无统计学意义(P>0.05)。结论临床治疗儿童斜视可考虑水平肌加强减弱术联合下斜肌减弱术,疗效突出,可显著改善眼表症状、眼表指数,缩短术后恢复时间,安全性高,进而改善其生活质量。

Objective To explore the clinical effect of combined treatment of weakening of strengthening and horizontal muscles and weakening of oblique muscles treating children with strabismus.Methods A retrospective analysis of 60 children with strabismus admitted to Gao′an People′s Hospital,Jiangxi Province from January 2018 to January 2019,with 92 affected eyes,they were divided into control group(30 patients received horizontal muscle strengthening and weakening surgery,42 eyes)and research group(30 cases received horizontal muscle strengthening and weakening combined with oblique muscle weakening,50 eyes)according to the treatment method.The total treatment efficiency,strabismus degree,and intraoperative blood loss,recovery time,vision recovery time,and complications were compared between two groups.Results The total effective rate of treatment in the research group was 93.33%,higher than that in the control group of 70.00%,the difference was statistically significant(P<0.05);before treatment,the difference in strabismus between the two groups was not statistically significant(P>0.05).The strabismus degree of the research group after 1,3 and 6 months after operation was lower than that of the control group,the difference was statistically significant(P<0.05);the comparison of the operation time between the two groups was not statistically significant(P>0.05);the intraoperative blood loss in the research group was less than that in the control group,the difference was statistically significant(P<0.05),the recovery time and the vision recovery time in the research group were shorter than those of the control group,the differences were statistically significant(P<0.05).The total incidence of complications between the two groups was not statistically significant(P>0.05).Conclusion Clinical treatment of children with strabismus may be given horizontal muscle strengthening and weakening combined with inferior oblique muscle weakening.The effect is outstanding,which can significantly improve the ocular surface symptoms and ocular surface index,shorten the postoperative recovery time,high safety,and then improve their life quality.