不同屈光状态、弱视程度及年龄段儿童弱视治疗的临床效果比较

李闽萍　邓琪琳　刘燕燕

【摘要】 目的：探究不同屈光狀态、弱视程度及年龄段儿童弱视治疗的临床效果。方法：选取本院2015年12月-2016年12月收治的128例屈光不正性弱视患儿为研究对象，根据屈光状态的差异将其分为近视性（25例）、远视性（76例）、混合型（27例）屈光不正三组；根据弱视程度将其分为轻度（39例）、中度（75例）、重度（14例）；按年龄段将其分为3～6岁59例、7～9岁42例，10～12岁27例；比较综合治疗后患儿的效果。结果：远视性屈光不正弱视组的治疗总有效率均明显高于其他两组，差异均有统计学意义（P<0.05），屈光状态与患儿治疗有效性密切相关（r=9.81，P<0.05）。不同弱视程度的患儿中，重度组患儿在治疗各阶段的总有效率均低于轻、中度组；中度组患儿在T3、T4阶段总有效率均明显低于轻度组，差异均有统计学意义（P<0.05）。3～6岁组患儿各个阶段总有效率均明显高于其他两组，差异均有统计学意义（P<0.05），年龄与患儿治疗有效性密切相关（r=11.09，P<0.05）。结论：弱视患儿的治疗效果与屈光不正性质、弱视程度等关系密切，且与年龄密切相关，通过尽早、综合的治疗有利于增强矫正效果。

【关键词】 屈光状态； 弱视； 儿童

Comparison of Clinical Effects of Amblyopia Treatment in Children with Different Refractive Status，Amblyopia Degree and Age/LI Minping，DENG Qilin，LIU Yanyan.//Medical Innovation of China，2018，15（14）：046-051

【Abstract】 Objective：To investigate the clinical effects of amblyopia treatment in children with different refractive status，amblyopia degree and age.Method：A total of 128 children with refractive amblyopia admitted from December 2015 to December 2016 in our hospital were selected.According to the difference of refractive state，they were divided into three groups：25 cases of myopia，76 cases of hyperopia and 27 cases of mixed type ametropia；acording to the degree of amblyopia，128 cases were divided into 39 cases with mild amblyopia，75 cases with moderate amblyopia and 14 cases with severe amblyopia；according to the degree of amblyopia，128 cases were divided into 3-6 years old 59 cases，7-9 years old 42 cases，10-12 years old 27 cases.The curative effects were compared after comprehensive treatment.Result：The total effective rate of hyperopic amblyopia group was significantly higher than those of the other two groups，the differences were statistically significant （P<0.05）；refractive status was closely related to the effectiveness of treatment in children（r=9.81，P<0.05）.Among the children with different amblyopia，the total effective rate in all stages of severe group was lower than those of mild and moderate group，in T3 and T4 stage of moderate group were significantly lower than those of mild group，the differences were statistically significant（P<0.05）.The total effective rate in all stages of 3-6 years old group were significantly higher than those of the other two groups，the differences were statistically significant（P<0.05）；the age was closely related to the effectiveness of treatment in children（r=11.09，P<0.05）.Conclusion：The treatment effect of amblyopia patients is closely related to the nature of refractive error and the degree of amblyopia，and is closely related to age，it is beneficial to enhance the correction effect through the early comprehensive treatment.

【Key words】 Refractive state； Amblyopia； Children

First-authors address：Pingxiang Maternal and Child Health Hospital，Pingxiang 337000，China

doi：10.3969/j.issn.1674-4985.2018.14.011

随着科技的发展、生活方式的改变，各类电子产品的不断普及，使我国儿童视力受损的发生率呈现上升态势，儿童的视力健康成为社会越来越关注的问题。有数据表明，目前我国儿童弱视的发病率约为3%[1]，弱视患儿表现为眼球运动障碍、分读困难、视力下降、屈光异常，若在发病的幼儿期未得到及时有效的治疗，则其成年后的视功能与正常人有异，严重时可致失明。因此弱视不仅不利于患儿的生活、学习，还会对其身心造成困扰，降低其生活质量。研究表明，弱视治疗的预后效果与患儿的依从性相关[2]，遵医嘱坚持治疗是提高疗效的重要因素[3]，不过其视力的一致性增高与疗程是否存在正相关关系尚不明确。本次研究以2015年12月-2016年12月本院收治的128例弱视儿童为研究对象，探究不同屈光状态在不同治疗阶段的临床效果，现报道如下。

1 资料与方法

1.1 一般资料 选取本院……