中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2015年
6期
654-656
,共3页
儿童%屈光不正性弱视%综合治疗%疗效
兒童%屈光不正性弱視%綜閤治療%療效
인동%굴광불정성약시%종합치료%료효
Children%Ametropic amblyopia%Comprehensive therapy%Curative efficacy
目的 分析屈光不正性弱视患儿的年龄因素、弱视类型和治疗方法对弱视治疗效果的影响.方法 临床病例系列研究.自2009年1月至2012年4月间,在天津市眼科医院的验光配镜中心收集弱视训练矫正的屈光不正性弱视患儿265例(450只眼),其中男126例,女139例,平均年龄(6.7±2.4)岁(3～12岁).根据患儿弱视程度和依从性,对所有患儿分别采用验光配镜、遮盖、压抑或综合治疗方法进行矫正,并随访观察其疗效.结果 265例(450只眼)弱视患几经治疗后最佳矫正视力均有不同程度提高,治疗前平均视力为0.39±0.24,治疗后平均视力为0.72±0.18,治疗前后视力差异有统计学意义(t =25.64,P=0.00).总有效率为90.4％ (407/450),不同年龄组患儿有效率差异有统计学意义(H=16.33,P=0.00),其中3～5岁组患儿疗效(98.3％,234/238)最好,6～8岁组患儿疗效(86.8％,118/136)次之,9～12岁组患儿疗效(72.4％,55/76)较差.由远视导致的屈光不正性弱视患儿疗效最佳(97.9％,279/285),其次是近视性弱视(81.6％,102/125),而散光导致的弱视疗效最差(65.0％,26/40),三组患儿之间疗效差异有统计学意义(H =50.94,P=0.00).采用验光配镜和遮盖相结合的综合治疗组患儿疗效(96.2％,256/266)明显高于单纯屈光矫正组(84.1％,116/138)和单纯压抑矫正组患儿(76.1％,35/46),疗效差异有统计学意义(H =11.84,P=0.00).结论 儿童屈光不正性弱视应在幼儿早期尽早采用综合治疗方法进行矫正治疗,其中远视性弱视患儿疗效明显.
目的 分析屈光不正性弱視患兒的年齡因素、弱視類型和治療方法對弱視治療效果的影響.方法 臨床病例繫列研究.自2009年1月至2012年4月間,在天津市眼科醫院的驗光配鏡中心收集弱視訓練矯正的屈光不正性弱視患兒265例(450隻眼),其中男126例,女139例,平均年齡(6.7±2.4)歲(3～12歲).根據患兒弱視程度和依從性,對所有患兒分彆採用驗光配鏡、遮蓋、壓抑或綜閤治療方法進行矯正,併隨訪觀察其療效.結果 265例(450隻眼)弱視患幾經治療後最佳矯正視力均有不同程度提高,治療前平均視力為0.39±0.24,治療後平均視力為0.72±0.18,治療前後視力差異有統計學意義(t =25.64,P=0.00).總有效率為90.4％ (407/450),不同年齡組患兒有效率差異有統計學意義(H=16.33,P=0.00),其中3～5歲組患兒療效(98.3％,234/238)最好,6～8歲組患兒療效(86.8％,118/136)次之,9～12歲組患兒療效(72.4％,55/76)較差.由遠視導緻的屈光不正性弱視患兒療效最佳(97.9％,279/285),其次是近視性弱視(81.6％,102/125),而散光導緻的弱視療效最差(65.0％,26/40),三組患兒之間療效差異有統計學意義(H =50.94,P=0.00).採用驗光配鏡和遮蓋相結閤的綜閤治療組患兒療效(96.2％,256/266)明顯高于單純屈光矯正組(84.1％,116/138)和單純壓抑矯正組患兒(76.1％,35/46),療效差異有統計學意義(H =11.84,P=0.00).結論 兒童屈光不正性弱視應在幼兒早期儘早採用綜閤治療方法進行矯正治療,其中遠視性弱視患兒療效明顯.
목적 분석굴광불정성약시환인적년령인소、약시류형화치료방법대약시치료효과적영향.방법 림상병례계렬연구.자2009년1월지2012년4월간,재천진시안과의원적험광배경중심수집약시훈련교정적굴광불정성약시환인265례(450지안),기중남126례,녀139례,평균년령(6.7±2.4)세(3～12세).근거환인약시정도화의종성,대소유환인분별채용험광배경、차개、압억혹종합치료방법진행교정,병수방관찰기료효.결과 265례(450지안)약시환궤경치료후최가교정시력균유불동정도제고,치료전평균시력위0.39±0.24,치료후평균시력위0.72±0.18,치료전후시력차이유통계학의의(t =25.64,P=0.00).총유효솔위90.4％ (407/450),불동년령조환인유효솔차이유통계학의의(H=16.33,P=0.00),기중3～5세조환인료효(98.3％,234/238)최호,6～8세조환인료효(86.8％,118/136)차지,9～12세조환인료효(72.4％,55/76)교차.유원시도치적굴광불정성약시환인료효최가(97.9％,279/285),기차시근시성약시(81.6％,102/125),이산광도치적약시료효최차(65.0％,26/40),삼조환인지간료효차이유통계학의의(H =50.94,P=0.00).채용험광배경화차개상결합적종합치료조환인료효(96.2％,256/266)명현고우단순굴광교정조(84.1％,116/138)화단순압억교정조환인(76.1％,35/46),료효차이유통계학의의(H =11.84,P=0.00).결론 인동굴광불정성약시응재유인조기진조채용종합치료방법진행교정치료,기중원시성약시환인료효명현.
Objective To analyze the impact of age,type of amblyopia and treatment methods on the outcome of the children with ametropic amblyopia.Methods From January 2009 to April 2012,265 cases (450 eyes) of patients with ametropic amblyopia were recruited in our optometry center.There were 126 cases with males and 139 cases with female.The average age was (6.7±2.4)years old (range from 3～12 years old).The patients were treated with the comprehensive treatment,simple refractive correction or pure penalization therapy based on their amblyopic degree and compliance.The outcomes were observed and followed up.Results After the treatment and one year followed-up,the best corrected visual acuity (BCVA) of all amblyopic patients was improved with different degree.The BCVA at initial visit and at the last visit were 0.39±0.24 and 0.72±0.18 respectively,and the difference was significant (t =25.64,P =0.00).The total successful rate was 90.4％(407/450),and the difference between the age groups was significant (H=16.33,P =0.00).The successful rate was higher at age from 3 to 5 years old (98.3％,234/238),and following with the group of 6 to 8 years old (86.8％,118/136) and the group of 9 to 12 years old (72.4％,55/76).The successful rate of the patients with hyperopic amblyopia (97.9％,279/285) was better,following with myopic amblyopia (81.6％,102/125) and astigmatic amblyopia (65.0％,26/40),and the difference was significant (H=50.94,P =0.00).The difference of successful rate with different type of treatment was significant (H=11.84,P =0.00),and the comprehensive treatment group (96.2％,256/266) was better than that of the simple refractive correction group (84.1％,116/138) or pure penalization therapy group (76.1％,35/46).Conclusions The children with ametropic amblyopia should be treated as earlier in younger ages with comprehensive methods,especially more effective for the hyperopic amblyopia.
