CAJ | 학술논문

目的：探讨下斜肌减弱术在先天性麻痹性垂直斜视患者中的应用效果。方法随机选取2009年6月—2014年6月先天性麻痹性垂直斜视例数60例,均给予下斜肌减弱手术,同时,按垂直斜度分成两组(实验组、对照组),分别给予下斜肌截腱术和下斜肌后徙转位前徙术治疗,统计手术效果。结果入选病例垂直斜视度治疗总有效率为91.7%(治愈51例,好转4例,5例轻度欠矫)其中,下斜肌肌腱部分截除术组临床治疗总有效率为93.3%,下斜肌后徙转位前徙术组治疗总有效率为83.3%,组间差异无统计学意义(P>0.05)；垂直斜度矫正度数3~10°不等,平均(6.32±1.24)°；30例代偿头位患者中,术后25例症状消失或改善；25例患者歪头试验为阳性患者中,术后20例歪头试验转为阴性；此外,术后2例患者有立体视觉,5例患者有融合功能,13例患者有同时视。结论下斜肌截下斜肌截腱术和下斜肌后徙转位前徙术均能有效治疗先天性麻痹性垂直斜视患者,均具备临床推广价值,值得各级医院应用。
목적：탐토하사기감약술재선천성마비성수직사시환자중적응용효과。방법수궤선취2009년6월—2014년6월선천성마비성수직사시례수60례,균급여하사기감약수술,동시,안수직사도분성량조(실험조、대조조),분별급여하사기절건술화하사기후사전위전사술치료,통계수술효과。결과입선병례수직사시도치료총유효솔위91.7%(치유51례,호전4례,5례경도흠교)기중,하사기기건부분절제술조림상치료총유효솔위93.3%,하사기후사전위전사술조치료총유효솔위83.3%,조간차이무통계학의의(P>0.05)；수직사도교정도수3~10°불등,평균(6.32±1.24)°；30례대상두위환자중,술후25례증상소실혹개선；25례환자왜두시험위양성환자중,술후20례왜두시험전위음성；차외,술후2례환자유입체시각,5례환자유융합공능,13례환자유동시시。결론하사기절하사기절건술화하사기후사전위전사술균능유효치료선천성마비성수직사시환자,균구비림상추엄개치,치득각급의원응용。
Objective To observe the effect of inferior oblique muscles weakening in the treatment of congenital paralytic vertical strabismus. Methods 60 patients with congenital paralytic vertical strabismus between June 2009 and June 2014 were given inferi-or oblique muscles weakening. They were divided into experimental group and control group according to degree of vertical strabis-mus, in which the disinsertion of the inferior oblique muscle and anterior transposition of the inferior oblique muscle were per-formed respectively. The effects of the two procedures were recorded. Results Of all the 60 patients, the effective rate was 91.7%with 51 cases cured, 4 cases improved and 5 cases mild under-correction, and statistical difference was found between the experi-mental group and the control group, which was 93.3% vs 83.3%. The degree of correction was 3~10°with an average of (6.32± 1.24)° . Of 30 patients with compensatory head posture, 25 experienced symptom disappearance or improvement; of 25 patients with positive responses in head tilting test, 20 became negative after operation. In addition, after operation, stereoscopic vision was found in 2 cases, fusion function in 5 cases and simultaneous perception in 13 patients. Conclusion Disinsertion of the inferior oblique muscle, as well as anterior transposition of the inferior oblique muscle, can effectively treat congenital paralytic vertical strabismus, therefore they are worthy of promotion and application in hospital of all levels.