吉林医学
吉林醫學
길림의학
JILIN MEDICAL JOURANL
2014年
12期
2509-2511
,共3页
弱视%综合治疗%效果%儿童
弱視%綜閤治療%效果%兒童
약시%종합치료%효과%인동
Amblyopia%Combined modality therapy%Effectiveness%Children
目的：总结分析一组弱视儿童3年综合治疗随访结果，观察不同年龄、不同类型、不同程度弱视治疗的疗效。方法：182例（276眼）3～13岁弱视儿童，男95例（157眼），女87例（119眼）。均用1%硫酸阿托品眼膏散瞳验光，并给予恰当的屈光矫正。每6～12个月重新验光1次，同时给予相应的遮盖疗法、药物、光学压抑法及各种视觉刺激疗法等综合疗法治疗，每个月复查视力，随访18～36个月，平均24个月。结果：本组弱视儿童治疗总有效率为90.22%，治愈占57.61%，进步占32.61%，无效占9.78%。其中3～6岁组总有效率为95.92%，优于7～13岁组的总有效率76.25%（P＜0.05）；轻度弱视总有效率为98.79%，中度弱视总有效率为82.95%，均明显优于重度弱视的总有效率为56.52%（P＜0.05）；屈光不正性弱视总有效率为94.76%，屈光参差性弱视总有效率为90.62%，均优于斜视性弱视的总有效率73.58%（P＜0.05）；中心注视总有效率为99.45%，明显优于旁中心注视的总有效率72.04%（P＜0.01）。结论：早期发现，早期干预，积极恰当的治疗可以最大限度地治愈儿童弱视。
目的：總結分析一組弱視兒童3年綜閤治療隨訪結果，觀察不同年齡、不同類型、不同程度弱視治療的療效。方法：182例（276眼）3～13歲弱視兒童，男95例（157眼），女87例（119眼）。均用1%硫痠阿託品眼膏散瞳驗光，併給予恰噹的屈光矯正。每6～12箇月重新驗光1次，同時給予相應的遮蓋療法、藥物、光學壓抑法及各種視覺刺激療法等綜閤療法治療，每箇月複查視力，隨訪18～36箇月，平均24箇月。結果：本組弱視兒童治療總有效率為90.22%，治愈佔57.61%，進步佔32.61%，無效佔9.78%。其中3～6歲組總有效率為95.92%，優于7～13歲組的總有效率76.25%（P＜0.05）；輕度弱視總有效率為98.79%，中度弱視總有效率為82.95%，均明顯優于重度弱視的總有效率為56.52%（P＜0.05）；屈光不正性弱視總有效率為94.76%，屈光參差性弱視總有效率為90.62%，均優于斜視性弱視的總有效率73.58%（P＜0.05）；中心註視總有效率為99.45%，明顯優于徬中心註視的總有效率72.04%（P＜0.01）。結論：早期髮現，早期榦預，積極恰噹的治療可以最大限度地治愈兒童弱視。
목적：총결분석일조약시인동3년종합치료수방결과，관찰불동년령、불동류형、불동정도약시치료적료효。방법：182례（276안）3～13세약시인동，남95례（157안），녀87례（119안）。균용1%류산아탁품안고산동험광，병급여흡당적굴광교정。매6～12개월중신험광1차，동시급여상응적차개요법、약물、광학압억법급각충시각자격요법등종합요법치료，매개월복사시력，수방18～36개월，평균24개월。결과：본조약시인동치료총유효솔위90.22%，치유점57.61%，진보점32.61%，무효점9.78%。기중3～6세조총유효솔위95.92%，우우7～13세조적총유효솔76.25%（P＜0.05）；경도약시총유효솔위98.79%，중도약시총유효솔위82.95%，균명현우우중도약시적총유효솔위56.52%（P＜0.05）；굴광불정성약시총유효솔위94.76%，굴광삼차성약시총유효솔위90.62%，균우우사시성약시적총유효솔73.58%（P＜0.05）；중심주시총유효솔위99.45%，명현우우방중심주시적총유효솔72.04%（P＜0.01）。결론：조기발현，조기간예，적겁흡당적치료가이최대한도지치유인동약시。
Objective To observe the clinical outcome of amblyopia in children after 3 years of treatment.To compare effectiveness of treatment among different age groups,types and severity groups of amblyopia.Methods 182 cases(276 eyes) aging from 3 years old to 13 years old,male 95 cases(157 eyes),female 87 cases(119 eyes).All of the patients were given 1%Atropine sulfate eye ointment for mydriatic refractometry and proper correction of refractive errors.Every 6 to 12 months,all the patients underwent a mydriatic refractometry and were given proper combination of the following management including occlusion treatment,medication,optical penalization and photic stimulation.Patients were followed up from 18 months to 36 months(ave. 24 months) with eyesight check up every month.Results The overall therapeutic efficacy in this group of patients was as high as 90.22%,cure rate 57.61%,improvement rate 32.61%and no effect 9.78%.Among which,age 3 to 6 years old group had an overall therapeutic efficacy as high as 95.92%while the 7 to 13 years age group had one only at 76.25%(P<0.05);mild amblyopia group had a therapeutic efficacy of 98.79%,moderate amblyopia group had a therapeutic efficacy of 82.95%,both of which were much higher than the severe group with a therapeutic efficacy only at 56.52%(P<0.05);group amblyopias had a therapeutic efficacy of 94.76%while group anisometropic amblyopia’s therapeutic efficacy was 90.62%,both of which were higher than that of group strabismic amblyopia at 73.58%(P<0.05);central fixation group’s therapeutic efficacy was 99.45% which was much better than that of eccentric fixation 72.04%(P<0.05). Conclusion To achieve optimal outcome,early diagnosis,early interference with aggressive combined therapy is highly recommended to cure amblyopia in children.
