调节功能训练在屈光不正性弱视儿童治疗中的临床应用

Clinical research of adjusting function training in the treatment of children with ametropic amblyopia

目的:探讨调节功能训练联合家庭传统疗法治疗屈光不正性弱视的临床疗效。方法:选取屈光不正性弱视儿童(105例210眼)按不同治疗方式分成两组。对照组(52例104眼)采用家庭传统治疗方法,实验组(53例106眼)在对照组基础上加入调节功能训练。治疗及随访12个月后,比较两组患儿的依从性、矫正视力提升的治疗效果、治疗前后调节功能、屈光状态、眼轴长的变化。结果:两组患儿依从性比较,差异无统计学意义(P=0.627)。实验组患儿矫正视力达“进步”“基本痊愈”所用平均时间(4.45±1.20个月、8.23±1.51个月)短于对照组(5.74±1.92个月、9.59±1.50个月),差异均有统计学意义(P<0.001)。12个月后,实验组患儿矫正视力提升的有效率为94.34%,高于对照组的83.65%(P=0.013);按年龄、程度、屈光原因分类比较,其中7~9岁、中度弱视、远视散光性弱视患儿,实验组治疗有效率优于对照组,差异有统计学意义(P<0.05)。治疗前两组的调节功能、等效球镜度、眼轴长比较,差异均无统计学意义(P>0.05)。治疗后实验组的调节幅度、调节灵敏度高于对照组,调节滞后量低于对照组,差异有统计学意义(P<0.05)。治疗后实验组中远视性弱视患儿的等效球镜度低于对照组,近视散光性、远视散光性弱视患儿的等效球镜度数高于对照组,差异有统计学意义(P<0.05)。治疗后实验组中远视性弱视患儿的眼轴长高于对照组,近视散光性、远视散光性弱视患儿的眼轴长均低于对照组,差异有统计学意义(P<0.05)。结论:在家庭传统疗法的基础上加入调节功能训练,可提升针对弱视患儿的治疗有效率并可对患儿的屈光度、眼轴等发挥有益的调节作用。

Objective:To explore the clinical efficacy of conditioning training combined with traditional family therapy in the treatment of refractive amblyopia.Methods:The children with refractive amblyopia(105 cases and 210 eyes)were selected continuously and divided into two groups according to different treatment methods.The control group(52 cases,104 eyes)used family traditional treatment methods,and the experimental group(53 cases,106 eyes)added adjustment function training on this basis.After treatment and follow-up for 12 months,the compliance and corrected visual acuity of the two groups were compared improved treatment effect,adjustment function before and after treatment,refractive status,changes in eye axis length.Results:There was no statistically significant difference in compliance between the two groups of children(P=0.627).The average time(4.45±1.20 months,8.23±1.51 months)for the children in the experimental group to achieve“improvement”and“basic recovery”were shorter than those of the control group(5.74±1.92 months,9.59±1.50 months),and the differences were statistically significant(P<0.001).After 12 months,the effective rate of correcting visual acuity of children in the experimental group was 94.34%higher than 83.65%of the control group(P=0.013).According to age,degree,and refractive causes,for children with mild amblyopia,hyperopia and astigmatism amblyopia aged 7~9 years old in the experimental group had better treatment efficiency than the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the adjustment function,equivalent spherical power,and axial length of the two groups before treatment(P>0.05).After treatment,the adjustment range and sensitivity of the experimental group were higher than those of the control group,and the amount of adjustment lag was lower than that of the control group.The difference was statistically significant(P<0.05).After treatment,the equivalent spherical power of children with hyperopic amblyopia in the experimental group was lower than that of the control group,and the equivalent spherical power of children with myopic astigmatism and hyperopic amblyopia was higher than that of the control group.The differences were statistically significant(P<0.05).After treatment,the axial length of children with hyperopia and amblyopia in the experimental group was higher than that of the control group,and the axial length of children with myopic astigmatism and hyperopia astigmatism amblyopia were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion:Adding adjustment function training on the basis of traditional family therapy can improve the treatment efficiency of children with amblyopia and can play a beneficial role in adjusting the refractive power and axis of the children.