间歇性外斜视远立体视及其相关因素的临床研究
发布时间：2018-08-19 09:42
【摘要】：目的:研究间歇性外斜视[Intermittent Exotropia,X(T)]远立体视的破坏与眼位控制力、斜视度数、年龄的相关性,及不同远距离控制力/斜视度数/年龄条件下间歇性外斜视患者术后早期远立体视功能的变化,并探讨各因素对手术时机选择的参考作用。方法:收集2016年5月至2016年11月入住我院的基本型X(T)患者79例(年龄:4-24岁)。按照手术年龄/远距离控制力/视远斜视度数依次将全部患者分为3组:年龄:组1,≤7岁;组2,7-13岁;组3,≥13岁;斜视度数:组Ⅰ,40△;组Ⅱ,40△-60△;组Ⅲ,60△;远距离控制力:组A:≤2分;组B,3分和4分;组C,5分。所有患者分别于术前、术后2周及10周行常规检查及远立体视功能检查。运用随机点同视机画片评估远立体视,术前至少三次评价远距离控制力。运用SPSS软件进行统计学分析,检验水准α=0.05。结果:一、年龄、斜视度数、控制力与远立体视的相关性分析1.年龄与远立体视的偏相关系数R=0.294,P0.05,认为差异有统计学意义,即二者相关,属于低度相关。2.视远斜视度数与远立体视的偏相关系数R=0.433,P0.05,差异有统计学意义,可以认为二者相关,属于中度相关。3.远距离控制力与远立体视的偏相关系数R=0.641,P=0.0000.05,差异有统计学意义,认为二者之间相关,且属于强相关。二、建立多元线性回归模型回归方程显著:Y^=-149.182+2.921X1+4.643X2+179.761X3,sig=0.0000.005,F=39.0090.001。三、X(T)患者术前、术后远立体视的变化79例X(T)患者中,术前仅9例(11.4%)患者远立体视正常(≤100″),术后2周有26例(32.9%)患者远立体视正常,术后10周有57例(72.2%)患者远立体视正常。术后2周、10周较术前差别有统计学意义(P0.05),术后10周较术后2周差别有统计学意义(P0.05)。四、按年龄分组的远立体视变化结果三组患者的远立体视术后2周、术后10周较术前明显改善(P0.05),术后10周较术后2周明显改善(P0.05)。大于13岁组术前仅3名(12.5%)患者有远立体视,术后2周时有9名(37.5%)患者有远立体视,术后10周时有21名(87.5%)患者恢复远立体视,较2周时有明显差异(P0.05)。五、按斜视度分组的远立体视变化结果三组患者的远立体视术后2周、术后10周较术前明显改善(P0.05),术后10周较术后2周明显改善(P0.05)。60PD组术前及术后2周分别有13人(61.9%)和5人(23.8%)无远立体视,术后10周时仍有3人(14.3%)无远立体视,较术后2周无明显差异(P0.05)。六、按控制力分组的远立体视变化结果三组患者的远立体视术后2周、术后10周较术前明显改善(P0.05),术后10周较术后2周明显改善(P0.05)。5分组术前及术后2周分别有3人(13.6%)和19人(86.4%)有远立体视,术后10周时有20人(95.2%)有远立体视,较术后2周无明显变化(P0.05)。结论:1.间歇性外斜视矫正手术能帮助维持较好的远立体视和改善已破坏的远立体视功能;2.在评价远立体视受损的严重程度时,较斜视度数和年龄而言,应该更多地考虑眼位的控制能力;3.即使X(T)患者的手术年龄延误到13岁之后,大多数患者的远立体视仍可恢复;4.在斜视度数大于60PD时行斜视矫正手术,X(T)患者的远立体视仅少数能恢复到正常;5.控制能力分数小于5分,即X(T)患者在检查时间内不是恒定斜视,绝大多数患者的远立体视可恢复正常。
[Abstract]:Objective: To study the relationship between the damage of distant stereopsis in intermittent exotropia (X (T)) and the ocular position control, strabismus degree, age, and the changes of early postoperative hyperopia in patients with intermittent exotropia under different distant control / strabismus degree / age, and to explore the factors influencing the choice of operation time. Methods: Seventy-nine patients with basic type X (T) admitted to our hospital from May 2016 to November 2016 (age: 4-24 years) were enrolled. All patients were divided into three groups according to the age of operation / distant control / hyperopia degree: age: group 1, < 7 years; group 2, 7-13 years; group 3, > 13 years; strabismus degree: group I, 40 Delta; group II, 40 Delta-60 Delta; group III, 60 Delta; Long-distance control ability: group A: < 2 points; group B, 3 points and 4 points; group C, 5 points. All patients underwent routine examination and far-distance stereopsis function examination before operation, 2 weeks and 10 weeks after operation. Random-point synoptophore was used to evaluate long-distance control ability at least three times before operation. Statistical analysis was carried out by SPSS software, and the test level was alpha = 0.05. Results: 1. Correlation analysis of age, strabismus degree, control power and far stereopsis 1. Partial correlation coefficient R = 0.294, P 0.05 between age and far stereopsis was statistically significant, that is, the correlation between them was low. 2. Partial correlation coefficient R = 0.433, P 0.05 between strabismus degree and far stereopsis was statistically significant. The partial correlation coefficient R = 0.641, P = 0.0000.05 was statistically significant. It was considered that there was a strong correlation between the two factors. Second, the regression equation of multiple linear regression model was significant: Y ^= - 149.182 + 2.921X1 + 4.643X 2 + 179.761X 3, sig = 0.0000.005, F = 39.0090.001.3, X (T) Among 79 X (T) patients before and after surgery, only 9 (11.4%) had normal hyperopia (< 100) before surgery, 26 (32.9%) had normal hyperopia 2 weeks after surgery, 57 (72.2%) had normal hyperopia 10 weeks after surgery. The difference was statistically significant (P 0.05) at 2 weeks and 10 weeks after surgery compared with 2 weeks after surgery. The difference was statistically significant (P 0.05). Fourthly, the changes of distant stereopsis in the three groups according to age were significantly improved at 2 weeks after operation (P 0.05) and 2 weeks after operation (P 0.05). Stereopsis was restored in 21 patients (87.5%) at 10 weeks after surgery, which was significantly different from that at 2 weeks (P There were 13 patients (61.9%) and 5 patients (23.8%) without farsightedness, 3 patients (14.3%) had no farsightedness at 10 weeks after operation, no significant difference compared with 2 weeks after operation (P 0.05). 5) There were 3 (13.6%) and 19 (86.4%) patients with hyperopia preoperatively and 2 weeks postoperatively. 20 (95.2%) patients had hyperopia at 10 weeks postoperatively, which had no significant change compared with 2 weeks postoperatively (P 0.05). When the severity of the impairment is greater than strabismus and age, more attention should be paid to the control of eye position. 3. Even if the operative age of X (T) patients is delayed to 13 years old, the hyperopia of most patients can be restored. 4. When strabismus is greater than 60 PD, strabismus correction is performed, and only a few of X (T) patients can restore hyperopia. Normally; 5. Control ability score less than 5 points, that is, X (T) patients in the examination time is not constant strabismus, the vast majority of patients with long-term stereopsis can return to normal.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R777.41
本文编号：2191283
[Abstract]:Objective: To study the relationship between the damage of distant stereopsis in intermittent exotropia (X (T)) and the ocular position control, strabismus degree, age, and the changes of early postoperative hyperopia in patients with intermittent exotropia under different distant control / strabismus degree / age, and to explore the factors influencing the choice of operation time. Methods: Seventy-nine patients with basic type X (T) admitted to our hospital from May 2016 to November 2016 (age: 4-24 years) were enrolled. All patients were divided into three groups according to the age of operation / distant control / hyperopia degree: age: group 1, < 7 years; group 2, 7-13 years; group 3, > 13 years; strabismus degree: group I, 40 Delta; group II, 40 Delta-60 Delta; group III, 60 Delta; Long-distance control ability: group A: < 2 points; group B, 3 points and 4 points; group C, 5 points. All patients underwent routine examination and far-distance stereopsis function examination before operation, 2 weeks and 10 weeks after operation. Random-point synoptophore was used to evaluate long-distance control ability at least three times before operation. Statistical analysis was carried out by SPSS software, and the test level was alpha = 0.05. Results: 1. Correlation analysis of age, strabismus degree, control power and far stereopsis 1. Partial correlation coefficient R = 0.294, P 0.05 between age and far stereopsis was statistically significant, that is, the correlation between them was low. 2. Partial correlation coefficient R = 0.433, P 0.05 between strabismus degree and far stereopsis was statistically significant. The partial correlation coefficient R = 0.641, P = 0.0000.05 was statistically significant. It was considered that there was a strong correlation between the two factors. Second, the regression equation of multiple linear regression model was significant: Y ^= - 149.182 + 2.921X1 + 4.643X 2 + 179.761X 3, sig = 0.0000.005, F = 39.0090.001.3, X (T) Among 79 X (T) patients before and after surgery, only 9 (11.4%) had normal hyperopia (< 100) before surgery, 26 (32.9%) had normal hyperopia 2 weeks after surgery, 57 (72.2%) had normal hyperopia 10 weeks after surgery. The difference was statistically significant (P 0.05) at 2 weeks and 10 weeks after surgery compared with 2 weeks after surgery. The difference was statistically significant (P 0.05). Fourthly, the changes of distant stereopsis in the three groups according to age were significantly improved at 2 weeks after operation (P 0.05) and 2 weeks after operation (P 0.05). Stereopsis was restored in 21 patients (87.5%) at 10 weeks after surgery, which was significantly different from that at 2 weeks (P There were 13 patients (61.9%) and 5 patients (23.8%) without farsightedness, 3 patients (14.3%) had no farsightedness at 10 weeks after operation, no significant difference compared with 2 weeks after operation (P 0.05). 5) There were 3 (13.6%) and 19 (86.4%) patients with hyperopia preoperatively and 2 weeks postoperatively. 20 (95.2%) patients had hyperopia at 10 weeks postoperatively, which had no significant change compared with 2 weeks postoperatively (P 0.05). When the severity of the impairment is greater than strabismus and age, more attention should be paid to the control of eye position. 3. Even if the operative age of X (T) patients is delayed to 13 years old, the hyperopia of most patients can be restored. 4. When strabismus is greater than 60 PD, strabismus correction is performed, and only a few of X (T) patients can restore hyperopia. Normally; 5. Control ability score less than 5 points, that is, X (T) patients in the examination time is not constant strabismus, the vast majority of patients with long-term stereopsis can return to normal.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R777.41
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