水平肌移位术治疗水平斜视并伴垂直斜视的临床效果观察

目的探讨水平肌移位术治疗水平斜视并伴垂直斜视的临床效果。方法选取我院2009年2月至2011年2月收治的诊断为水平斜视并伴垂直斜视的患者56例（83只眼）,对其临床病历资料进行回顾性分析,均采取水平肌移位术治疗,选择行内外直肌止端的上下移位量〈3 mm的患者为观察组A,共32例（51只眼）;选择行内外直肌止端的上下移位量为5～7 mm的患者为观察组B,共24例（32只眼）,再选择10例（12只眼）无进行内外直肌移位术的患者设为对照组,观察对比三组患者的视力矫正效果。结果观察组A平均矫正的垂直斜视度数为1.76°±0.45°;观察组B平均矫正的垂直斜视度数为4.57°±0.79°;对照组平均矫正的垂直斜视度数为1.24°±0.36°,3组患者平均矫正垂直斜视度数对比存在明显差异（P〈0.05）,具有统计学意义。结论水平肌移位术治疗水平斜视并伴垂直斜视的临床效果显著,水平肌的移位量均在5mm以上,平均矫正垂直斜视度数最为明显,安全可靠。

Clinical effects of shift horizontal muscle operation for the treatment of horizontal strabismus with vertical strabismus

Objective To observe the clinical effects of shift horizontal muscle operation in the treatment of horizontal strabismus with vertical strabismus and summarize its clinical value.Methods 56 patients who were diagnosed as the horizontal strabismus with vertical strabismus from Feb.2009 to Feb.2011(83 eyes in total) and underwent were retrospectively analyzed.Patients all received the shift horizontal muscle operation.Chose patients who had the up and down shift of superior and inferior rectus insertion less than 3mm as the observation group A,with 32 cases in total(51 eyes);patients who had up and down shift of superior and inferior rectus insertion from 5 to 7 mm as the observation group B,with 24 cases in total(32 eyes);while 10 patients(12 eyes) without the shift operation of superior and inferior rectus as the control group.Observed and compared the effects of vision correction of patients in three groups.Results The average corrected degree of vertical strabismus for observation group A was 1.76°±0.45°;the one for observation group B was 4.57°±0.79°;while the one for the control group was 1.24°±0.36°.There was a statistically significant difference in the average corrected degree of vertical strabismus among three groups(P<0.05).Conclusion There is a significant clinical effect of shift horizontal muscle operation in the treatment of horizontal strabismus with vertical strabismus,with the shift amount of horizontal muscle over 5mm on average.The average corrected degree of vertical strabismus is especially significant.It is safe and reliable,which is worthy to be popularized and applied during the clinical practice.