中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2015年
4期
378-383
,共6页
陈霞琳%陈金卯%陶崇飞%魏艳飞
陳霞琳%陳金卯%陶崇飛%魏豔飛
진하림%진금묘%도숭비%위염비
下斜肌转位术%下斜肌功能亢进%分离性垂直偏斜%抑制上转综合征
下斜肌轉位術%下斜肌功能亢進%分離性垂直偏斜%抑製上轉綜閤徵
하사기전위술%하사기공능항진%분리성수직편사%억제상전종합정
Anterior transposition of the inferior oblique muscle%Inferior oblique over-action%Dissociated vertical deviation%Anti-elevation syndrome
目的 评价下斜肌转位术对伴有下斜肌功能亢进的垂直分离性偏斜的疗效.方法 临床病例系列研究.对2009年2月至2013年8月在广西医科大学第一附属医院眼科就诊的22例(26只眼)行下斜肌转位治疗伴有下斜肌功能亢进的分离性垂直偏斜(DVD)病例资料进行回顾性分析,比较手术前后33cm及5 m垂直斜视度变化、下斜肌功能减弱情况以及单双眼下斜肌转位术后发生抑制上转综合征(AES)的情况.结果 (1) 22例患者术前33cm平均垂直斜视度(21.12±9.49) PD,术后(3.92±6.35) PD(t=9.026,P=0.000);术前5 m平均垂直斜视度(21.00±8.83) PD,术后(4.12±7.25) PD(t =8.819,P=0.000).(2)术前下斜肌亢进平均(3.04±0.79),术后平均(0.20±0.87),差异有统计学意义(z =-4.432,P=0.000).(3)双眼下斜肌转位4例中1例以及单眼下斜肌转位加对侧眼下斜肌切断7例中1例术后出现抑制上转综合征(AES),仅行单眼下斜肌转位11例中6例术后出现AES.结论 下斜肌转位术是治疗合并下斜肌亢进的DVD的有效手术方式,双眼下斜肌亢进的DVD可采取双侧下斜肌转位或者单侧下斜肌转位联合对侧下斜肌切断,单眼下斜肌亢进的DVD不建议首选下斜肌转位术.
目的 評價下斜肌轉位術對伴有下斜肌功能亢進的垂直分離性偏斜的療效.方法 臨床病例繫列研究.對2009年2月至2013年8月在廣西醫科大學第一附屬醫院眼科就診的22例(26隻眼)行下斜肌轉位治療伴有下斜肌功能亢進的分離性垂直偏斜(DVD)病例資料進行迴顧性分析,比較手術前後33cm及5 m垂直斜視度變化、下斜肌功能減弱情況以及單雙眼下斜肌轉位術後髮生抑製上轉綜閤徵(AES)的情況.結果 (1) 22例患者術前33cm平均垂直斜視度(21.12±9.49) PD,術後(3.92±6.35) PD(t=9.026,P=0.000);術前5 m平均垂直斜視度(21.00±8.83) PD,術後(4.12±7.25) PD(t =8.819,P=0.000).(2)術前下斜肌亢進平均(3.04±0.79),術後平均(0.20±0.87),差異有統計學意義(z =-4.432,P=0.000).(3)雙眼下斜肌轉位4例中1例以及單眼下斜肌轉位加對側眼下斜肌切斷7例中1例術後齣現抑製上轉綜閤徵(AES),僅行單眼下斜肌轉位11例中6例術後齣現AES.結論 下斜肌轉位術是治療閤併下斜肌亢進的DVD的有效手術方式,雙眼下斜肌亢進的DVD可採取雙側下斜肌轉位或者單側下斜肌轉位聯閤對側下斜肌切斷,單眼下斜肌亢進的DVD不建議首選下斜肌轉位術.
목적 평개하사기전위술대반유하사기공능항진적수직분리성편사적료효.방법 림상병례계렬연구.대2009년2월지2013년8월재엄서의과대학제일부속의원안과취진적22례(26지안)행하사기전위치료반유하사기공능항진적분리성수직편사(DVD)병례자료진행회고성분석,비교수술전후33cm급5 m수직사시도변화、하사기공능감약정황이급단쌍안하사기전위술후발생억제상전종합정(AES)적정황.결과 (1) 22례환자술전33cm평균수직사시도(21.12±9.49) PD,술후(3.92±6.35) PD(t=9.026,P=0.000);술전5 m평균수직사시도(21.00±8.83) PD,술후(4.12±7.25) PD(t =8.819,P=0.000).(2)술전하사기항진평균(3.04±0.79),술후평균(0.20±0.87),차이유통계학의의(z =-4.432,P=0.000).(3)쌍안하사기전위4례중1례이급단안하사기전위가대측안하사기절단7례중1례술후출현억제상전종합정(AES),부행단안하사기전위11례중6례술후출현AES.결론 하사기전위술시치료합병하사기항진적DVD적유효수술방식,쌍안하사기항진적DVD가채취쌍측하사기전위혹자단측하사기전위연합대측하사기절단,단안하사기항진적DVD불건의수선하사기전위술.
Objective To evaluate the efficacy of anterior transposition of the inferior oblique muscle (ATIO) for the treatment of dissociated vertical deviation (DVD) combined with inferior oblique overaction (IOOA).Methods Twenty-two patients (26 eyes) that treated surgically at the first affiliated Hospital of Guangxi Medical University,Nanning,China from February 2009 to August 2013 were studied retrospectively.All patients were performed ATIO for DVD with coexisting IOOA.The amount of vertical deviation in primary position was compared between pre-and post-operation at either 5m or 33cm distance respectively.The degree of inferior oblique over-action was compared between pre-and post-operation.The incidence of anti-elevation syndrome (AES) was compared between the cases performing unilateral and bilateral ATIO.Results The mean vertical deviation in primary position at 33cm was (21.12±9.49)PD preoperatively.It had decreased to (3.92±6.35) PD postoperatively (t =9.026,P =0.000).The mean vertical deviation in primary position at 5m was (21.00±8.83)PD preoperatively,and was (4.12±7.25)PD after operation (t =8.819,P =0.000).Mean inferior oblique over-action decreased from (3.04±0.79) to (0.20±0.87) (z =-4.432,P =0.000).It was statistically significant difference.There were 1 of the 4 cases who performing bilateral ATIO,1 of the 7 cases who performing unilateral ATIO while the other eye underwent myotenotomy of the inferior blique muscle,and 6 of the 11 cases who only performing unilateral ATIO showed AES after the operation.Conclusions ATIO is an effective treatment for DVD combined with IOOA.The DVD with bilateral inferior oblique over-action can be taken the bilateral inferior oblique transposition or unilateral inferior oblique transposition jointly contralateral inferior oblique cut,but monocular inferior oblique transposition surgery is not the first choice of monocular inferior oblique over-action DVD.
