HirschbergTest与KrimskyTest在儿童斜视角测量中准确性及可靠性研究

发布时间：2018-06-27 13:42

  本文选题：儿童斜视 + 斜视角测量　； 参考：《广州医学院》2011年硕士论文

【摘要】：目的: 研究临床上使用Hirschberg Test及Krimsky Test在儿童斜视角测量中的准确性和可靠性,帮助临床医师更好的使用这两种常见的斜视角检查方法以及更为准确的理解其检查结果。 方法: 选取50名共同性水平斜视患儿,由同一医师完成三棱镜交替遮盖检查测量斜视度,此结果作为斜视角度对照组。由同一医师使用数码相机完成眼位照片收集,共5张眼位照片○1第一眼位照片○2斜视眼注视○3注视眼(或斜视眼)前放置三棱镜,棱镜度等于三棱镜交替遮盖检查结果○4注视眼(或斜视眼)前放置三棱镜,棱镜度小于三棱镜交替遮盖检查结果10棱镜度○5注视眼(或斜视眼)前放置三棱镜,棱镜度大于三棱镜交替遮盖检查结果10棱镜度。由4名有经验的斜视与小儿眼科医师在同一时间段使用Hirschberg Test完成对患儿斜视角度测量(传统Hirschberg Test);4名检查者浏览眼位照片○1○2 ,使用Hirschberg Test判断斜视角度,记录检查结果(图片Hirschberg Test);4名检查者浏览眼位照片○3○4○5 ,使用Krimsky Test判断照片中的棱镜度数为合适、过矫、欠矫,记录检查结果。使用统计学方法分析测量结果。 结果: 1.使用Hirschberg Test(包括传统Hirschberg Test及图片Hirschberg Test)及Krimsky Test测量斜视角度,4名检查者测量结果存在差异,差异具有统计学意义。 2.以三棱镜交替遮盖检查结果为参考值,图片Hirschberg Test的检查结果比传统Hirschberg Test的检查结果更为准确,差异具有统计学意义。 3.当Kappa角为阴性时,4名检查者使用Hirschberg Test及Krimsky Test测量斜视角度均比Kappa角为阳性时更为准确,差异具有统计学意义。 4.当斜视度≥50棱镜度时,使用Krimsky Test检查结果准确性低于斜视度50棱镜度时使用Krimsky Test的检查结果,差异具有统计学意义。 结论: Hirschberg Test和Krimsky Test均不是精确测量斜视角度的方法,对于儿童斜视患者,检查结果因人而异。其结果受检查者的主观因素、斜视角度、Kappa角等因素的影响。对于不适合三棱镜交替遮盖检查的斜视患儿,临床上需要一种更为精确的斜视角度测量方法。
[Abstract]:Objective: to study the accuracy and reliability of Hirschberg Test and Krimsky Test in the measurement of oblique angle of view in children. Methods: 50 children with concomitant horizontal strabismus were examined by the same doctor to measure the degree of strabismus. A digital camera was used by the same doctor to collect the eye position photos. A total of 5 eye position photos 01 first eye image 02 strabismus eye fixation eye (or strabismus eye) placed a prism before 03 fixation eye (or strabismus eye). Prism degree is equal to alternate prism shading examination result 04 prism in front of fixation eye (or strabismus eye), prism degree is less than that of prism alternately covering examination result 10 prism degree 05 gaze eye (or strabismus eye) placed prism before eye (or squint eye), The prism degree is larger than the prism alternately shaded check result 10 prism degree. Four experienced strabismus and pediatric ophthalmologists used Hirschberg Test to measure the squint angle (traditional Hirschberg Test) in the same time period. Four examiners browsed eye position photos 0102 and used Hirschberg Test to judge strabismus angle. Record the results of the examination (Hirschberg Test). Four examiners browsed the eye position photo 030405 and used Krimsky Test to judge the prism degree in the photo as appropriate, overcorrection, undercorrection, and record the results of the examination. The results were analyzed by statistical method. Results: 1. Hirschberg Test (including traditional Hirschberg Test and Picture Hirschberg Test) and Krimsky Test were used to measure strabismus angle. The results of Hirschberg Test were more accurate than those of traditional Hirschberg Test, and the difference was statistically significant. When the Kappa angle was negative, the four examiners used Hirschberg Test and Krimsky Test to measure strabismus angle more accurately than when Kappa angle was positive, the difference was statistically significant. 4. When squint degree 鈮，

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