肌腹下眶-球硅管连接术与肌腹下注射A型肉毒素治疗麻痹性斜视的效果对比

发布时间：2018-06-28 07:01

本文选题：麻痹性斜视 + 眶-球硅管连接术　；参考：《眼科新进展》2015年09期

【摘要】：目的探讨在麻痹肌肌腹下行眶-球硅管连接术与肌腹下注射A型肉毒素治疗麻痹性斜视的疗效对比。方法收集36例(36眼)斜视患者,根据治疗方法不同分为两组,A组行肌腹下眶-球硅管连接术,B组行A型肉毒素眼外肌注射治疗,每组各18例(18眼)。记录术后1周与6 a时两组患者的临床效果、角膜散光、视功能及屈光度变化等情况。结果 A组患者术后均达到美容性眼位矫正;12例(66.7%)达到功能性眼位矫正;治疗1周后角膜前表面屈光度、散光值及散光轴向与治疗前相比明显增加,治疗6 a后角膜前表面屈光度、散光值及散光轴向基本恢复至术前水平;A组术后1周8例患者存在双眼视功能,随访6 a 14例存在双眼视功能。B组患者术后12例(66.7%)达到美容性眼位矫正;达到功能性眼位矫正者9例(50.0%);治疗1周后及随访6 a角膜前表面屈光度、散光值及散光轴向与治疗前相比差异均无统计学意义(均为P0.05);B组术后1周6例患者存在双眼视功能,随访6 a 7例存在双眼视功能;两组治疗后1周近视度数相比差异无统计学意义(P0.05),随访6 a,A组近视度数为(-3.52±2.82)D,B组为(-5.78±3.42)D,A组明显低于B组(P0.05)。结论肌腹下眶-球硅管连接术与肌腹下注射A型肉毒素相比,在临床效果、角膜散光、视功能方面均有明显差异,眶-球硅管连接术是治疗麻痹性斜视的可行方法,值得推广。
[Abstract]:Objective to compare the therapeutic effects of orbital-bulbar silicon tube connection with intramuscular injection of botulinum toxin type A in the treatment of paralytic strabismus. Methods 36 cases (36 eyes) of strabismus were divided into two groups according to different treatment methods: group A was treated with intraocular injection of botulinum toxin A (18 eyes). The clinical effect, corneal astigmatism, visual function and diopter were recorded at 1 week and 6 years after operation. Results in group A, 12 cases (66.7%) achieved cosmetic eye position correction, 1 week after treatment, corneal anterior surface diopter, astigmatism value and astigmatism axial direction were significantly increased compared with those before treatment. After 6 years of treatment, the corneal anterior surface diopter, astigmatism value and astigmatism axial direction basically recovered to the preoperative level. In group A, 8 patients had binocular vision function 1 week after operation. In group B, 12 cases (66.7%) achieved cosmetic correction, 9 cases (50.0%) achieved functional ocular position correction, 1 week after treatment and 6 years after follow-up, the corneal anterior surface refraction was observed. There was no significant difference in astigmatism and axial astigmatism between before and after treatment (P0.05). In group B, 6 patients had binocular visual function 1 week after operation, and 7 patients had binocular visual function after 6 years follow-up. There was no significant difference in myopia between the two groups 1 week after treatment (P0.05). The myopia degree of group A was (-3.52 卤2.82) DU B group was (-5.78 卤3.42) DPA group was significantly lower than that of group B (P0.05). Conclusion there are significant differences in clinical effect, corneal astigmatism and visual function between intramuscular surgery and intramuscular injection of botulinum toxin A. It is a feasible method for the treatment of paralytic strabismus and is worth popularizing.
【作者单位】：南昌大学第一附属医院眼科;
【基金】：国家自然科学基金资助(编号:81160118、81400372) 全国临床医药研究专项基金(编号:L2012052) 江西省远航工程(编号:2014022) 江西省学位与研究生教育教学改革研究项目(编号:2015) 江西省科技平台建设项目(编号:2013116) 江西省青年科学基金(编号:20151BAB215016) 江西省科技支撑计划项目(编号:20151BBG70223) 江西省教育厅科技计划项目(编号:GJJ14170) 江西省卫计委科技计划项目(编号:20155154) 赣江学者计划(编号:2015)~~
【分类号】：R779.6

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