中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
15期
23-25
,共3页
眼外科手术%分离性垂直偏斜%下斜肌亢进
眼外科手術%分離性垂直偏斜%下斜肌亢進
안외과수술%분리성수직편사%하사기항진
Ophthalmologic surgical procedures%Dissociated vertical deviation%Inferior oblique muscle overreaction
目的 评价标准下斜肌前转位术和下斜肌前转位联合部分切除术在分离性垂直偏斜(DVD)治疗中的效果.方法 DVD患者36例(59眼),按随机数字表法分为两组,标准下斜肌前转位术组(30眼)和下斜肌前转位联合部分切除术组(29眼),观察对比术后3个月时的垂直斜视度变化和下斜肌功能状况.结果 标准下斜肌前转位术组30眼术后3个月第一眼位垂直斜视度为0△～10△(3.5△±2.7△)(三棱镜度),下斜肌前转位联合部分切除术组29眼术后3个月第一眼位垂直斜视度为0△～12△(3.3△±3.6△),两组比较差异无统计学意义(P＞0.05).术后3个月标准下斜肌前转位术组下斜肌功能2眼为+2级,7眼为+1级,21眼为0级,下斜肌前转位联合部分切除术组下斜肌功能1眼为+2级,4眼为+1级,24眼为0级,两组比较差异无统计学意义(P＞0.05).两组术后均未出现下斜视.结论 下斜肌前转位术可作为治疗DVD的首选术式,并可用于不伴有下斜肌功能亢进的DVD治疗.下斜肌前转位联合部分切除术并没有显著增加手术效果.
目的 評價標準下斜肌前轉位術和下斜肌前轉位聯閤部分切除術在分離性垂直偏斜(DVD)治療中的效果.方法 DVD患者36例(59眼),按隨機數字錶法分為兩組,標準下斜肌前轉位術組(30眼)和下斜肌前轉位聯閤部分切除術組(29眼),觀察對比術後3箇月時的垂直斜視度變化和下斜肌功能狀況.結果 標準下斜肌前轉位術組30眼術後3箇月第一眼位垂直斜視度為0△～10△(3.5△±2.7△)(三稜鏡度),下斜肌前轉位聯閤部分切除術組29眼術後3箇月第一眼位垂直斜視度為0△～12△(3.3△±3.6△),兩組比較差異無統計學意義(P＞0.05).術後3箇月標準下斜肌前轉位術組下斜肌功能2眼為+2級,7眼為+1級,21眼為0級,下斜肌前轉位聯閤部分切除術組下斜肌功能1眼為+2級,4眼為+1級,24眼為0級,兩組比較差異無統計學意義(P＞0.05).兩組術後均未齣現下斜視.結論 下斜肌前轉位術可作為治療DVD的首選術式,併可用于不伴有下斜肌功能亢進的DVD治療.下斜肌前轉位聯閤部分切除術併沒有顯著增加手術效果.
목적 평개표준하사기전전위술화하사기전전위연합부분절제술재분리성수직편사(DVD)치료중적효과.방법 DVD환자36례(59안),안수궤수자표법분위량조,표준하사기전전위술조(30안)화하사기전전위연합부분절제술조(29안),관찰대비술후3개월시적수직사시도변화화하사기공능상황.결과 표준하사기전전위술조30안술후3개월제일안위수직사시도위0△～10△(3.5△±2.7△)(삼릉경도),하사기전전위연합부분절제술조29안술후3개월제일안위수직사시도위0△～12△(3.3△±3.6△),량조비교차이무통계학의의(P＞0.05).술후3개월표준하사기전전위술조하사기공능2안위+2급,7안위+1급,21안위0급,하사기전전위연합부분절제술조하사기공능1안위+2급,4안위+1급,24안위0급,량조비교차이무통계학의의(P＞0.05).량조술후균미출현하사시.결론 하사기전전위술가작위치료DVD적수선술식,병가용우불반유하사기공능항진적DVD치료.하사기전전위연합부분절제술병몰유현저증가수술효과.
Objective To assess the clinical effect of anterior transposition of the inferior oblique muscle (ATTO) with and without resection in the treatment of dissociated vertical deviation (DVD). Methods Thirty-six patients ( 59 eyes ) with DVD were divided into the standard group ( 30 eyes) and the resection group (29 eyes) by random digits table undertaking ATIO with and without a 7-mm resection. The vertical deviation degree in primary position and the eyeball motility were recorded and evaluated. Results The vertical deviation degree in primary position were 0△-10△ (3.5 △± 2.7△) after 3 months operation in the standard group,while 0△-12△ (3.3△±3.6△) in the resection group. There were no significant differences between two groups (P＞ 0.05). In the standard group, 2 cases revealed +2 inferior oblique muscle overaction (IOOA), 7 cases revealed +1 and 21 cases revealed 0 after 3 months operation. In the resection group, 1 case revealed +2 IOOA, 4 cases revealed +1 and 24 cases revealed 0 after 3 months operation. There were no significant differences between two groups(P＞ 0.05 ). The presence or absence of IOOA did not influence the result of ATIO for either group. Conclusions ATIO is an effective treatment for DVD and can be used to treat DVD in patients without IOOA. A 7-mm resection with the standard ATIO has no advantage to improve the surgery outcome.
