CAJ | 학술논문

目的：比较不同类型间歇性外斜视使用注视6m示标三棱镜检查、注视30 m示标、注视户外示标、1 h遮盖试验四种测量方法测量斜视角结果的差别。 　　方法：前瞻性研究。收集2013-06/2014-06在青岛大学医学院附属医院被确诊为间歇性外斜视的患者65例,其中男37例,女28例,平均年龄12.5±6.2岁。分别对患者行注视6 m示标斜视度测量、注视30 m示标斜视度测量、注视户外示标斜视度测量、1h遮盖试验斜视度测量。根据测量远近斜视角差值大小,将患者分为基本型、集合不足型、分开过强型。对各型中测量的视远斜视度进行单因素方差分析,采用LSD-t方法进行两两比较。 　　结果：注视6m示标、注视30m示标、注视户外示标、1h遮盖试验四种检测方法测得的视远斜视度在三型中分别为：基本型45.4±21.0,55.0±15.0,64.68±17.7,68.75±16.6PD；集合不足型33.3±14.0,44.9±12.9,43.6±11.8,&nbsp；54.6±11.2PD；分离过强型55.6±17.4,66.3±18.8,76.9±16.4,78.1±15.6PD,三型中四种方法测得的视远斜视度进行比较,结果均有统计学意义( F基本型=9.649,P=0.00；F集合不足型=6.886,P=0.001；F分离过强型=7.989,P=0.00)。两两比较,注视户外示标(P基本型=0.044,P分离过强型=0.048)及1h遮盖试验(P基本型=0.04,P分离过强型=0.027)与注视30m示标检查比较时,在基本型与分离过强型两型中差异均有统计学意义；注视户外示标检查与1h遮盖试验( P基本型=0.353,P分离过强型=0.815)在基本型与分离过强型两型中的比较差异无统计学意义。而在集合不足型中,与其它三种检查方法相比,1h遮盖试验检查结果明显更大,差异有统计学意义。 　　结论：注视户外示标与1h遮盖试验可以测出基本型与分离过强型更大的斜视角,在集合不足型1h遮盖试验可以测出更大斜视角。
목적：비교불동류형간헐성외사시사용주시6m시표삼릉경검사、주시30 m시표、주시호외시표、1 h차개시험사충측량방법측량사시각결과적차별。 　　방법：전첨성연구。수집2013-06/2014-06재청도대학의학원부속의원피학진위간헐성외사시적환자65례,기중남37례,녀28례,평균년령12.5±6.2세。분별대환자행주시6 m시표사시도측량、주시30 m시표사시도측량、주시호외시표사시도측량、1h차개시험사시도측량。근거측량원근사시각차치대소,장환자분위기본형、집합불족형、분개과강형。대각형중측량적시원사시도진행단인소방차분석,채용LSD-t방법진행량량비교。 　　결과：주시6m시표、주시30m시표、주시호외시표、1h차개시험사충검측방법측득적시원사시도재삼형중분별위：기본형45.4±21.0,55.0±15.0,64.68±17.7,68.75±16.6PD；집합불족형33.3±14.0,44.9±12.9,43.6±11.8,&nbsp；54.6±11.2PD；분리과강형55.6±17.4,66.3±18.8,76.9±16.4,78.1±15.6PD,삼형중사충방법측득적시원사시도진행비교,결과균유통계학의의( F기본형=9.649,P=0.00；F집합불족형=6.886,P=0.001；F분리과강형=7.989,P=0.00)。량량비교,주시호외시표(P기본형=0.044,P분리과강형=0.048)급1h차개시험(P기본형=0.04,P분리과강형=0.027)여주시30m시표검사비교시,재기본형여분리과강형량형중차이균유통계학의의；주시호외시표검사여1h차개시험( P기본형=0.353,P분리과강형=0.815)재기본형여분리과강형량형중적비교차이무통계학의의。이재집합불족형중,여기타삼충검사방법상비,1h차개시험검사결과명현경대,차이유통계학의의。 　　결론：주시호외시표여1h차개시험가이측출기본형여분리과강형경대적사시각,재집합불족형1h차개시험가이측출경대사시각。
AlM: To compare the results of 4 methods for measuring angle of exodeviation in the three types of intermittent exotropia, including when looking at indoor distance target of 6m, looking at indoor distance target of 30m, looking at outdoor far distance target, after 1h diagnostic occlusion test. METHODS: Prospective case series study. Sixty-five patients with intermittent exotropia between June 2013 and June 2014 were enrolled in the Department of Ophthalmology, Affiliated Hospital to Qingdao University, included 37 males and 28 females with average age ( 12. 5 ± 6. 2 ) years. All the patients were measured when looking at indoor distance target of 6m, looking at indoor distance target of 30m, looking at outdoor far distance target, after 1h diagnostic occlusion test. lntermittent exotropia was divided into basic type, convergence insufficiency type and divergence excess type, which was based on the different result of between the distance and near measurements. The One-way test was applied to analyze the four methods of measuring angle of exodeviation in the three types of intermittent exotropia. LSD - t test was applied to compare the differences between each two methods in each type. RESULTS: The distance exodeviations tested with looking at indoor distance target of 6m, looking at indoor distance target of 30m , looking at outdoor far distance target, after 1h diagnostic occlusion test were basic type (45. 4 ± 21. 0, 55. 0 ± 15. 0, 64. 68 ± 17. 7, 68. 75 ± 16. 6PD), convergence insufficiency type (33. 3 ± 14. 0, 44. 9 ± 12. 9, 43. 6±11. 8, 54. 6±11. 2PD), divergence excess type (55. 6± 17.4, 66.3±18.8, 76.9±16.4, 78.1±15.6PD). There were obviously differences between each two methods in each type ( basic type F = 9. 649, P = 0. 00; convergence insufficiency type F=6. 886, P=0. 001; divergence excess type F = 7. 989, P = 0. 00 ). Compared with looking at indoor distance target of 30m, looking at outdoor far distance target ( basic type P=0. 044, divergence excess type P = 0. 048 ) and after 1h diagnostic occlusion test (basic type P=0. 04, divergence excess type P=0. 027) had the statistical difference in the basic type and divergence excess type, and there was no obviously difference between looking at outdoor far distance target and after 1h diagnostic occlusion test ( basic type P=0. 353, divergence excess type P=0. 815). Compared with the other three measurements, 1h diagnostic occlusion test can elicit larger angle of deviation in the convergence insufficiency type. CONCLUSlON: Both measurement with looking at outdoor far distance target and after 1h diagnostic occlusion test can elicit the larger angle of deviation in the basic type and divergence excess type; The measurement with after 1 hour diagnostic occlusion test can elicit the larger angle of deviation in the convergence insufficiency type.