双眼外直肌后徙术治疗小儿间歇性外斜视的临床疗效分析

Analysis of clinical efficacy of binocular lateral rectus recession in the treatment of intermittent exotropia in children

目的探讨小儿间歇性外斜视(IXT)采用双眼外直肌后徙术治疗的临床疗效。方法选择84例IXT患儿为研究对象,采用随机数字表法分为对照组和观察组,每组42例。对照组实施单眼外直肌后徙术联合内直肌缩短术,观察组实施双眼外直肌后徙术。比较两组矫正效果、斜视度数、融合功能与立体视恢复情况、生活质量。结果两组过矫率、欠矫率比较,差异无统计学意义(P>0.05);观察组正矫率90.48%高于对照组的73.81%,差异有统计学意义(P<0.05)。观察组融合功能恢复率为64.29%,立体视恢复率为71.43%,高于对照组的40.48%、50.00%,差异有统计学意义(P<0.05)。术后6个月,两组斜视度数均较本组术前降低,且观察组斜视度数(5.29±0.30)PD明显低于对照组的(10.24±1.18)PD,差异有统计学意义(P<0.05)。术后3、6个月,观察组欧洲五维健康量表(EQ-5D)评分分别为(82.03±9.13)、(89.75±10.23)分,显著高于对照组的(72.81±10.39)、(78.96±12.02)分,差异有统计学意义(P<0.05)。结论小儿IXT应用双眼外直肌后徙术治疗的矫正效果较好,能改善视功能,降低斜视度数,是一种理想的治疗方案。

Objective To discuss the clinical efficacy of binocular lateral rectus recession in the treatment of intermittent exotropia(IXT)in children.Methods A total of 84 children with IXT were selected as the research subjects,and were divided into the control group and the observation group by random numerical table,with 42 cases in each group.The control group underwent monocular lateral rectus recession combined with medial rectus shortening,while the observation group underwent binocular lateral rectus recession.The correction effect,strabismus degree,fusion function,recovery of stereopsis,and quality of life were compared between the two groups.Results There was no statistically significant difference in the overcorrection rate and undercorrection rate between the two groups(P>0.05).The correction rate of the observation group was 90.48%,which was higher than 73.81%of the control group,and the difference was statistically significant(P<0.05).The recovery rate of fusion function in the observation group was 64.29%,and the recovery rate of stereopsis was 71.43%,which were higher than 40.48%and 50.00%in the control group,and the differences were all statistically significant(P<0.05).At 6 months after surgery,the strabismus degree of the two groups was lower than that of this group before surgery;the strabismus degree of the observation group was(5.29±0.30)PD,which was significantly lower than(10.24±1.18)PD of the control group;the differences were all statistically significant(P<0.05).At 3 and 6 months after surgery,the European quality of life 5-dimensions(EQ-5D)scores in the observation group were(82.03±9.13)and(89.75±10.23)points,which were significantly higher than(72.81±10.39)and(78.96±12.02)points in the control group,and the differences were all statistically significant(P<0.05).Conclusion The treatment of IXT in children with binocular lateral rectus recession has a better correction effect,and can improve visual function and reduce strabismus degree,which is an ideal treatment scheme.