儿童斜视手术病例分析及术后立体视觉恢复影响因素研究

发布时间：2018-07-11 18:44

本文选题：斜视 + 分类　；参考：《吉林大学》2011年硕士论文

【摘要】：斜视是儿童发病率较高的眼部疾病之一,不仅影响美容,更重要的是影响正常视力的发育,可能导致弱视和立体视觉无法正常发育,还使儿童承受社会歧视的心理压力,会给学习和生活以及今后的择业带来不良影响。近年来,我国儿童的斜视防治工作有了很大进展,许多眼科医生和家长逐渐认识到斜视给儿童带来的严重后果。目的:了解我院儿童斜视的类型分布、儿童斜视手术时机的选择等,以期指导临床工作。另外分析斜视患者手术后立体视恢觉复情况,讨论其影响因素,为斜视患者提供最佳的治疗方案,提高治疗效果,提供理论依据。方法:2010年3月到2011年5月期间吉林大学第二医院斜视与小儿眼病科收治的儿童斜视患者(患者年龄均小于等于14岁,行斜视矫正术)病历作回顾性研究,分析其斜视类型分布、发现斜视年龄分布、手术年龄分布、临床表现等情况。对按时回院检查立体视觉的儿童做立体视觉恢复情况及相关危险因素分析。结果:①在此期间,我院眼科中心共收治505名14岁及以下儿童斜视患者,并于全麻或局麻下行斜视矫正术。所有病人中,共同性内斜视患者为78例,占15.5%,共同性外斜视患者318例,占63.0%,麻痹性斜视患者78例,占15.5%。其它为特殊类型斜视,包括DVD(1.0%)、Duane眼球后退综合征(0.6%)、V型内斜视、V型外斜视以及A型斜视等共31例(6.0%)。其中年龄最大者14岁,最小者16个月。②不同年龄分层中各种斜视类型的分布差异经检验具有统计学意义(χ2=29.02,P0.05)。另外各种斜视类型在有无家族史分组中、是否伴发弱视分组中、能否控制正位分组中、术前立体视觉正常与否分组中及不同发现斜视年龄分组中分布均有差异,且差异有统计学意义(P0.05)。③通过单因素分析和多因素Logistic回归分析,发现斜视年龄、病程、能否控制正位及术后立体视觉训练是影响术后立体视觉恢复的因素。结论:①儿童斜视手术患者中共同性外斜视比例高于共同性内斜视。②不同类型斜视的年龄构成、斜视发现年龄、家族史、控制正位情况、弱视发生情况、术前立体视觉情况等分布不同。③通过单因素分析和多因素Logistic回归分析,发现斜视年龄、病程、能否控制正位及术后立体视觉训练是影响术后立体视觉恢复的因素。
[Abstract]:Strabismus is one of the eye diseases with high incidence in children. It not only affects beauty, but also affects the development of normal vision, which may lead to amblyopia and stereoscopic vision, and make children suffer psychological pressure of social discrimination. Will have a negative impact on study and life, as well as future career choices. In recent years, great progress has been made in the prevention and treatment of strabismus among children in China. Many ophthalmologists and parents have come to realize the serious consequences of strabismus on children. Objective: to investigate the distribution of strabismus in children and the choice of surgical opportunity for children strabismus in order to guide the clinical work. In addition, the situation of stereoscopic vision recovery after operation in strabismus patients was analyzed, and the influencing factors were discussed, so as to provide the best treatment plan for strabismus patients, to improve the therapeutic effect and to provide theoretical basis for the treatment of strabismus patients. Methods: from March 2010 to May 2011, the medical records of children with strabismus and infantile ophthalmopathy in the second Hospital of Jilin University were retrospectively studied and their strabismus types were analyzed. The age distribution of strabismus, the age distribution of operation and the clinical manifestation were found. The recovery of stereoscopic vision and related risk factors were analyzed in children who returned to hospital on time. Results during this period, 505 children with strabismus under 14 years old were treated in the ophthalmic center of our hospital, and the orthopedics was performed under general anesthesia or local anesthesia. Among all the patients, 78 cases were concomitant esotropia, 318 cases were concomitant exotropia, 78 cases were paralytic strabismus. Other types of strabismus included DVD (1.0%) Duane's receding syndrome (0.6%), V-esotropia, V-type exotropia and type A strabismus in 31 cases (6.0%). Among them, the oldest was 14 years old, and the youngest was 16 months. 2 the distribution difference of different strabismus types in different age stratification was statistically significant (蠂 2 / 29.02 P 0.05). In addition, there were differences in the distribution of strabismus in the groups with or without family history, whether accompanied with amblyopia, whether or not to control the positive position, whether the stereovision was normal or not before operation and in the age groups with different found strabismus. The difference was statistically significant (P0.05). By univariate analysis and multivariate logistic regression analysis, it was found that strabismus age, course of disease, control of orthopedics and stereoscopic training after operation were the factors affecting the recovery of stereopsis. Conclusion the proportion of concomitant exotropia in children with strabismus of 1: 1 is higher than that in concomitant esotropia .2 different types of strabismus. The age, family history, control of positive position and amblyopia are found in strabismus. By univariate analysis and multivariate logistic regression analysis, it was found that age of strabismus, course of disease, control of orthopedics and stereoscopic training after operation were the factors affecting the recovery of stereopsis.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.6

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