综合疗法治疗儿童弱视821例疗效分析

目的:探讨综合疗法治疗儿童弱视临床疗效,并给予评价。方法:对821例1510眼儿童弱视进行综合治疗,并对其疗效进行跟踪随访3年以上。结果:痊愈率44.90%,进步46.82%,总有效率91.72%,无效8.28%。其中屈光不正性弱视痊愈率51.04%,明显高于屈光参差性、斜视性弱视和形觉剥夺性弱视;轻度弱视痊愈率86.93%,明显高于中度和重度弱视;3岁以下和3～8岁痊愈率明显高于11～14岁和15岁以上;中心注视痊愈率46.83%,明显高于旁中心注视率19.63%;屈光度低度组(球镜≤3.00 D,柱镜≤1.00 D)痊愈率66.13%,明显高于中度(球镜3.25～4.75 D,柱镜1.25～1.50 D)28.88%和高度(球镜≥5.00D,柱镜≥1.75 D)18.93%。屈光类型以单纯远视痊愈率54.31%,明显高于其他屈光类型。结论:儿童弱视治疗效果与弱视类型、程度、注视性质、屈光度高低、屈光类型以及治疗时年龄有密切关系;采用综合疗法治疗儿童弱视可以提高治愈率,采用复方托吡卡胺散瞳验光与阿托品散瞳验光疗效相同。提倡上学时不遮盖,每周遮盖35 h,由家长和弱视儿童自主安排遮盖时间,从而提高了依从性和痊愈率。

Analysis on clinical efficacy of combined therapy in treatment of 821 children with amblyopia

Objective:To explore the clinical efficacy of combined therapy in treatment of children with amblyopia,and evaluated the efficacy.Methods:1 510 eyes of 821 children were treated with combined therapy,then the clinical efficacy was followed up for three years.Results:The recovery rate was 44.90%,and the improvement rate was 46.82%.The total effective rate was 91.72%,and the ineffective rate was 8.28%.The recovery rate of ametropic amblyopia was 51.04%,which was significantly higher than those of anisometropic amblyopia,strabismic amblyopia and form deprivation amblyopia.The recovery rate of mild amblyopia was 86.93%,which was significantly higher than those of moderate and severe amblyopia.The recovery rates of amblyopia of children under 3 years and 3～8 years old were significantly higher than those over 15 years and 1 1～14 years old.The recovery rate of central fixation was 46.83%,which was significantly higher than that of paracentral fixation(19.63%).The recovery rate of low diopter group(spherical≤3.00 D,cylinder≤1.00 D) was 66.13%,which was significantly higher than those of moderate diopter group(spherical:3.25～4.75 D,cylinder:1.25～1.50 D) (28.88%) and height diopter group(spherical≥5.00 D,Cylinder≥1.75 D)(18.93%).The recovery rate of simple hypermetropia was 54.31%,which was significantly higher than other refractive types.Conclusion:The clinical efficacy of amblyopia is related to amblyopic types,degrees,fixation nature,refraction,refractive types and age closely.Combined therapy can improve the recovery rate,the clinical efficacies of tropicamide compound and atropine are the same.Cover isnt advocated,covering 35 hours per week may improve the compliance and recovery rate.