儿童共同性斜视手术中显微镜手术的临床分析

李萍

[摘要] 目的 观察分析儿童共同斜视手术中采用显微镜手术效果。 方法 整群选取医院从2013年8月—2014年7月收治的88例儿童共同性斜视患者为研究对象，均分为两组，对照组44例肉眼直视下实施传统手术，观察组44例实施显微镜下斜视术，比较分析不同手术实施效果。结果 观察组术后正位率93.2%，完全治愈90.9%，对照组术后正位率93.2%，完全治愈86.4%，观察组患者的眼位矫正效果以及临床疗效比较差异无统计学意义，P>0.05，观察组患者术中出血5.0%、角膜上皮损伤剥脱1.7%、眼-胃肠反射发生率1.7%以及术后结膜肉芽肿发生率1.7%明显少于对照组术中出血13.8%、角膜上皮损伤剥脱6.9%、眼-胃肠反射发生率3.4%以及术后结膜肉芽肿发生率8.6%，差异有统计学意义，P<0.05。 结论 儿童共同斜视采用显微镜下斜视矫正术，术野清晰，可有效提高手术治疗效果，减少并发症发生，疗效显著。

[关键词] 儿童；共同斜视；显微镜

[中图分类号] R779.6 [文献标识码] A [文章编号] 1674-0742（2015）11（b）-0010-03

[Abstract] Objective To observe the effect of concomitant strabismus surgery under microscope in children. Methods 88 children with concomitant strabismus admitted in our hospital from August 2013 to July 2014 were selected as the subjects and divided into two groups， the control group and the observation group with 44 cases in each. Patients in the control group were treated by the traditional surgery under the naked eye， while those in the observation group were treated by the strabismus surgery under microscope. And the surgical effects of the two groups were analyzed comparatively. Results The postoperative correction rate was 93.2% and the cure rate was 90.9% in the observation group， and that was 93.2%， 86.4%， respectively in the control group， the differences in the postoperative correction rate and the cure rate between the two groups were not statistically significant， P>0.05. Compared with the control group， the observation group had much lower incidence of intraoperative blood loss（5.0% vs 13.8%）， obviously lower incidence of corneal epithelial injury and exfoliation（1.7% vs 6.9%）， significantly lower eye and stomach reflex rate（1.7% vs 3.4%）， substantially lower incidence of postoperative conjunctival granuloma（1.7% vs 8.6%） with statistically significant differences， P<0.05. Conclusion Children with concomitant strabismus surgery under microscope can have clear surgical field， effectively improve the surgical outcome and reduce the incidence of complications with a significant effect.

[Key words] Children； Concomitant strabismus； Microscope

共同性斜视矫正术多发于儿童，合并弱视，影响患儿的视觉发育。因此，临床应早期采取措施，矫正眼位，恢复正常视觉。临床主要采用手术方法，但选择哪种手术方法，是临床研究的重点[1]。显微镜下手术因视野清晰，手术操作精细准确，减少损伤，提高手术效果。该次研究中，整群选取该院从2013年8月—2014年7月收治的88例儿童共同斜视患者，观察采用显微镜下儿童共同性斜视术的效果，现报道如下。

1 资料与方法

1.1 一般资料

整群选取该院从2013年8月—2014年7月收治的88例儿童共同斜视患者，均分为两组，对照组44例（58眼），男24例，女20例，年龄为3～11岁，平均年龄为（6.5±0.3）岁，共同性内斜视26例，共同性外斜视18例。观察组44例（60眼），男25例，女19例，年龄为3～11岁，平均年龄为（6.5±0.3）岁，共同性内斜视28例，共同性外斜视16例。统……