分开麻痹的临床特点及疗效评价

发布时间：2018-04-26 08:44

本文选题：分开麻痹 + 三棱镜　；参考：《眼科新进展》2017年02期

【摘要】：目的通过对分开麻痹临床特点的分析,提高对该病的认识并评价非手术和手术治疗的临床效果。方法回顾性研究。连续收集2014年9月至2016年1月在天津市眼科医院确诊并接受治疗的11例分开麻痹患者完整的临床资料,包括一般资料、神经科会诊以及治疗前后眼位、眼球运动、斜视度、双眼视觉状态、AC/A、复视像检查,通过随访进行疗效评价。所有患者随访3~18个月,平均6.9个月。结果研究中1例患者有Miller-Fisher综合征病史,3例有高血压病史,1例有安眠类药物摄入史。11例患者均表现为看远同侧复视,急性起病,神经科会诊及头颅MRI、CT正常,均伴有屈光不正。治疗前斜视度数5 m:+25△~+55△,33 cm:+8△~+40△;双眼外转落后1~3 mm;AC/A为2.0~4.0,平均2.9。10例行手术治疗,1例屈光矫正基础上加配三棱镜,其中外直肌手术缩短量为4.0~7.5 mm、内直肌后徙量为4.0 mm。末次随访时复视均消失,斜视度数5 m:-4△~+12△,33 cm:-8△~+8△;双眼外转落后0~2 mm;AC/A为1.3~4.0,平均2.6。结论分开麻痹具有视远内斜视度数大、同侧复视的临床特点,外直肌加强手术对改善复视及内斜视具有较好的疗效。
[Abstract]:Objective to improve the understanding of the disease and evaluate the clinical effect of non-operative and surgical treatment by analyzing the clinical characteristics of separated paralysis. Methods retrospective study. From September 2014 to January 2016, the complete clinical data of 11 patients diagnosed and treated in Tianjin Ophthalmology Hospital were collected, including general data, neurology consultation, eye position, eye movement, strabismus before and after treatment. The binocular visual status was evaluated by AC / A, double vision examination and follow-up. All patients were followed up for 3 ~ 18 months (mean 6.9 months). Results one patient had a history of Miller-Fisher syndrome and 3 had a history of hypertension. One patient had a history of sleeping drug intake. All of the 11 patients showed distant ipsilateral diplopia, acute onset, normal neurologic consultation and cranial MRI CT, all with ametropia. Before treatment, the degree of strabismus was 5 m: 25 ~ 55 v 33 cm: 8 ~ 40, and the distance of bilateral extravasation was 1 ~ 3 mm. Ac / A was 2.0 卤4.0, with an average of 2.9.10 cases treated by surgery with a prism on the basis of refractive correction in 1 case. The shortening of external rectus surgery was 4.0 mm and the internal rectus recession was 4.0 mm. At the last follow-up, the diplopia disappeared, the squint number was 5 m: -4 ~ 12 and 33 cm:-8 ~ 8, and the average AC / A was 1.3 卤4.0 (mean 2.6). Conclusion the separated paralysis has the clinical characteristics of large degree of far esotropia and ipsilateral diplopia. The enhanced operation of external rectus muscle has a better effect on the improvement of diplopia and esotropia.
【作者单位】：天津医科大学眼科临床学院天津市眼科医院天津市眼科研究所天津市眼科学与视觉科学重点实验室;
【分类号】：R777.45

【相似文献】