共同性斜视患儿矫正术后双眼视功能恢复不佳的因素分析

Analysis of factors influencing poor recovery of binocular vision function in children with concomitant strabismus after correction

目的探讨共同性斜视患儿矫正术后双眼视功能恢复不佳的相关影响因素。方法回顾性分析2019年1~10月在蚌埠医学院第一附属医院行矫正手术的100例共同性斜视患儿的临床病历资料。术后均随访3个月,根据术后双眼视功能恢复情况将其分为恢复良好组与恢复不佳组。采用单因素与多因素logistic回归分析法分析影响患儿术后双眼视功能恢复不佳的相关危险因素。结果矫正术术后随访3个月,100例共同性斜视患儿中有30例双眼视功能恢复不佳者,恢复不佳率为30.00%(30/100);恢复不佳组与恢复良好组的发病年龄、斜视类型比较,差异无统计学意义(P>0.05);恢复不佳组手术年龄>8岁、病程>1年、术前矫正视力<0.8、术后残余斜视度>4Δ的构成比分别为53.33%、73.33%、20.00%、26.67%,均明显高于恢复良好组(28.57%、47.14%、5.71%、8.57%),差异有统计学意义(P<0.05)。经logistic回归分析,手术年龄>8岁、病程>1年、术前矫正视力<0.8、术后残余斜视度>4Δ均是影响共同性斜视患儿矫正术后双眼视功能恢复不佳的危险因素(OR=3.053、3.124、2.552、3.171,P<0.05)。结论共同性斜视患儿矫正术后存在双眼视功能恢复不佳的情况,且手术年龄>8岁、病程>1年、术前矫正视力<0.8、术后残余斜视度>4Δ均是影响此类患儿术后双眼视功能恢复的危险因素,此对临床工作具有指导价值。

Objective To explore the related influencing factors of poor recovery of binocular vision function in children with concomitant strabismus after correction.Methods The clinical data of 100 children with concomitant strabismus who underwent corrective surgery in the First Affiliated Hospital of Bengbu Medical College from January to October 2019 were retrospectively analyzed,who were followed up for 3 months after surgery,and they were divided into good recovery group and poor recovery group according to the recovery of binocular vision function after operation,then the risk factors affecting poor recovery of binocular vision function were analyzed after surgery in children were analyzed by single factor and multiple factor logistic regression analysis method,and the preventive suggestions were put forward on this basis.Results Following-up for 3 months after correction,there were 30 children with poor binocular vision function in 100 children with concomitant strabismus,and the rate of poor recovery was 30.00%(30/100).There was no statistically significant difference in the age of onset and type of strabismus between the poorly recovery group and the good recovery group(P>0.05).The proportion of operative age>8 years old,course of disease>1 year,preoperative corrected visual acuity<0.8,residual strabismus after operation>4Δin the poor recovery group were 53.33%,73.33%,20.00%,26.67%,which were significantly higher than those in the good recovery group(28.57%,47.14%,5.71%,8.57%),the difference was statistically significant(P<0.05).The logistic regression analysis showed that the proportion of operative age>8 years old,course of disease>1 year,preoperative corrected visual acuity<0.8,residual strabismus after operation>4Δwere risk factors for affecting the poor recovery of binocular visual function in children with concomitant strabismus after correction(OR=3.053,3.124,2.552,3.171,P<0.05).Conclusion There are poor recovery of binocular visual function in children with concomitant strabismus after correction,and the operative age>8 years old,course of disease>1 year,preoperative corrected visual acuity<0.8,residual strabismus after operation>4Δare the risk factors affecting the recovery of binocular visual function in children with concomitant strabismus after operation,which has guiding value for clinical work.