【摘要】：目的:研究間歇性外斜視[Intermittent Exotropia,X(T)]遠(yuǎn)立體視的破壞與眼位控制力、斜視度數(shù)、年齡的相關(guān)性,及不同遠(yuǎn)距離控制力/斜視度數(shù)/年齡條件下間歇性外斜視患者術(shù)后早期遠(yuǎn)立體視功能的變化,并探討各因素對(duì)手術(shù)時(shí)機(jī)選擇的參考作用。方法:收集2016年5月至2016年11月入住我院的基本型X(T)患者79例(年齡:4-24歲)。按照手術(shù)年齡/遠(yuǎn)距離控制力/視遠(yuǎn)斜視度數(shù)依次將全部患者分為3組:年齡:組1,≤7歲;組2,7-13歲;組3,≥13歲;斜視度數(shù):組Ⅰ,40△;組Ⅱ,40△-60△;組Ⅲ,60△;遠(yuǎn)距離控制力:組A:≤2分;組B,3分和4分;組C,5分。所有患者分別于術(shù)前、術(shù)后2周及10周行常規(guī)檢查及遠(yuǎn)立體視功能檢查。運(yùn)用隨機(jī)點(diǎn)同視機(jī)畫片評(píng)估遠(yuǎn)立體視,術(shù)前至少三次評(píng)價(jià)遠(yuǎn)距離控制力。運(yùn)用SPSS軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,檢驗(yàn)水準(zhǔn)α=0.05。結(jié)果:一、年齡、斜視度數(shù)、控制力與遠(yuǎn)立體視的相關(guān)性分析1.年齡與遠(yuǎn)立體視的偏相關(guān)系數(shù)R=0.294,P0.05,認(rèn)為差異有統(tǒng)計(jì)學(xué)意義,即二者相關(guān),屬于低度相關(guān)。2.視遠(yuǎn)斜視度數(shù)與遠(yuǎn)立體視的偏相關(guān)系數(shù)R=0.433,P0.05,差異有統(tǒng)計(jì)學(xué)意義,可以認(rèn)為二者相關(guān),屬于中度相關(guān)。3.遠(yuǎn)距離控制力與遠(yuǎn)立體視的偏相關(guān)系數(shù)R=0.641,P=0.0000.05,差異有統(tǒng)計(jì)學(xué)意義,認(rèn)為二者之間相關(guān),且屬于強(qiáng)相關(guān)。二、建立多元線性回歸模型回歸方程顯著:Y^=-149.182+2.921X1+4.643X2+179.761X3,sig=0.0000.005,F=39.0090.001。三、X(T)患者術(shù)前、術(shù)后遠(yuǎn)立體視的變化79例X(T)患者中,術(shù)前僅9例(11.4%)患者遠(yuǎn)立體視正常(≤100″),術(shù)后2周有26例(32.9%)患者遠(yuǎn)立體視正常,術(shù)后10周有57例(72.2%)患者遠(yuǎn)立體視正常。術(shù)后2周、10周較術(shù)前差別有統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后10周較術(shù)后2周差別有統(tǒng)計(jì)學(xué)意義(P0.05)。四、按年齡分組的遠(yuǎn)立體視變化結(jié)果三組患者的遠(yuǎn)立體視術(shù)后2周、術(shù)后10周較術(shù)前明顯改善(P0.05),術(shù)后10周較術(shù)后2周明顯改善(P0.05)。大于13歲組術(shù)前僅3名(12.5%)患者有遠(yuǎn)立體視,術(shù)后2周時(shí)有9名(37.5%)患者有遠(yuǎn)立體視,術(shù)后10周時(shí)有21名(87.5%)患者恢復(fù)遠(yuǎn)立體視,較2周時(shí)有明顯差異(P0.05)。五、按斜視度分組的遠(yuǎn)立體視變化結(jié)果三組患者的遠(yuǎn)立體視術(shù)后2周、術(shù)后10周較術(shù)前明顯改善(P0.05),術(shù)后10周較術(shù)后2周明顯改善(P0.05)。60PD組術(shù)前及術(shù)后2周分別有13人(61.9%)和5人(23.8%)無(wú)遠(yuǎn)立體視,術(shù)后10周時(shí)仍有3人(14.3%)無(wú)遠(yuǎn)立體視,較術(shù)后2周無(wú)明顯差異(P0.05)。六、按控制力分組的遠(yuǎn)立體視變化結(jié)果三組患者的遠(yuǎn)立體視術(shù)后2周、術(shù)后10周較術(shù)前明顯改善(P0.05),術(shù)后10周較術(shù)后2周明顯改善(P0.05)。5分組術(shù)前及術(shù)后2周分別有3人(13.6%)和19人(86.4%)有遠(yuǎn)立體視,術(shù)后10周時(shí)有20人(95.2%)有遠(yuǎn)立體視,較術(shù)后2周無(wú)明顯變化(P0.05)。結(jié)論:1.間歇性外斜視矯正手術(shù)能幫助維持較好的遠(yuǎn)立體視和改善已破壞的遠(yuǎn)立體視功能;2.在評(píng)價(jià)遠(yuǎn)立體視受損的嚴(yán)重程度時(shí),較斜視度數(shù)和年齡而言,應(yīng)該更多地考慮眼位的控制能力;3.即使X(T)患者的手術(shù)年齡延誤到13歲之后,大多數(shù)患者的遠(yuǎn)立體視仍可恢復(fù);4.在斜視度數(shù)大于60PD時(shí)行斜視矯正手術(shù),X(T)患者的遠(yuǎn)立體視僅少數(shù)能恢復(fù)到正常;5.控制能力分?jǐn)?shù)小于5分,即X(T)患者在檢查時(shí)間內(nèi)不是恒定斜視,絕大多數(shù)患者的遠(yuǎn)立體視可恢復(fù)正常。
[Abstract]:Objective: To study the relationship between the damage of distant stereopsis in intermittent exotropia (X (T)) and the ocular position control, strabismus degree, age, and the changes of early postoperative hyperopia in patients with intermittent exotropia under different distant control / strabismus degree / age, and to explore the factors influencing the choice of operation time. Methods: Seventy-nine patients with basic type X (T) admitted to our hospital from May 2016 to November 2016 (age: 4-24 years) were enrolled. All patients were divided into three groups according to the age of operation / distant control / hyperopia degree: age: group 1, < 7 years; group 2, 7-13 years; group 3, > 13 years; strabismus degree: group I, 40 Delta; group II, 40 Delta-60 Delta; group III, 60 Delta; Long-distance control ability: group A: < 2 points; group B, 3 points and 4 points; group C, 5 points. All patients underwent routine examination and far-distance stereopsis function examination before operation, 2 weeks and 10 weeks after operation. Random-point synoptophore was used to evaluate long-distance control ability at least three times before operation. Statistical analysis was carried out by SPSS software, and the test level was alpha = 0.05. Results: 1. Correlation analysis of age, strabismus degree, control power and far stereopsis 1. Partial correlation coefficient R = 0.294, P 0.05 between age and far stereopsis was statistically significant, that is, the correlation between them was low. 2. Partial correlation coefficient R = 0.433, P 0.05 between strabismus degree and far stereopsis was statistically significant. The partial correlation coefficient R = 0.641, P = 0.0000.05 was statistically significant. It was considered that there was a strong correlation between the two factors. Second, the regression equation of multiple linear regression model was significant: Y ^= - 149.182 + 2.921X1 + 4.643X 2 + 179.761X 3, sig = 0.0000.005, F = 39.0090.001.3, X (T) Among 79 X (T) patients before and after surgery, only 9 (11.4%) had normal hyperopia (< 100) before surgery, 26 (32.9%) had normal hyperopia 2 weeks after surgery, 57 (72.2%) had normal hyperopia 10 weeks after surgery. The difference was statistically significant (P 0.05) at 2 weeks and 10 weeks after surgery compared with 2 weeks after surgery. The difference was statistically significant (P 0.05). Fourthly, the changes of distant stereopsis in the three groups according to age were significantly improved at 2 weeks after operation (P 0.05) and 2 weeks after operation (P 0.05). Stereopsis was restored in 21 patients (87.5%) at 10 weeks after surgery, which was significantly different from that at 2 weeks (P There were 13 patients (61.9%) and 5 patients (23.8%) without farsightedness, 3 patients (14.3%) had no farsightedness at 10 weeks after operation, no significant difference compared with 2 weeks after operation (P 0.05). 5) There were 3 (13.6%) and 19 (86.4%) patients with hyperopia preoperatively and 2 weeks postoperatively. 20 (95.2%) patients had hyperopia at 10 weeks postoperatively, which had no significant change compared with 2 weeks postoperatively (P 0.05). When the severity of the impairment is greater than strabismus and age, more attention should be paid to the control of eye position. 3. Even if the operative age of X (T) patients is delayed to 13 years old, the hyperopia of most patients can be restored. 4. When strabismus is greater than 60 PD, strabismus correction is performed, and only a few of X (T) patients can restore hyperopia. Normally; 5. Control ability score less than 5 points, that is, X (T) patients in the examination time is not constant strabismus, the vast majority of patients with long-term stereopsis can return to normal.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R777.41

【參考文獻(xiàn)】

相關(guān)期刊論文 前7條

1 郭智一;許江濤;;兒童共同性外斜視矯正術(shù)后立體視覺(jué)康復(fù)的臨床觀察[J];中國(guó)斜視與小兒眼科雜志;2016年01期

2 江明石;;立體視覺(jué)對(duì)間歇性外斜視手術(shù)時(shí)機(jī)選擇的臨床研究[J];中國(guó)初級(jí)衛(wèi)生保健;2015年08期

3 張?chǎng)?;青少年間歇性外斜視手術(shù)前后立體視覺(jué)的臨床觀察[J];中華眼科醫(yī)學(xué)雜志(電子版);2014年03期

4 姚雪輝;管永清;夏春曉;;間歇性外斜視眼位控制力與雙眼視覺(jué)關(guān)系研究[J];中國(guó)實(shí)用眼科雜志;2014年03期

5 鐔魯濱;杜改萍;馬汀;黃一飛;;間歇性外斜視矯正術(shù)后患者立體視覺(jué)恢復(fù)和影響因素[J];眼科新進(jìn)展;2014年01期

6 韋嚴(yán);亢曉麗;趙堪興;;間歇性外斜視的研究進(jìn)展[J];中華眼科雜志;2011年11期

7 李月平;馬惠芝;;間歇性外斜視不同視差立體視的臨床觀察[J];中國(guó)實(shí)用眼科雜志;2009年01期

相關(guān)碩士學(xué)位論文 前2條

1 欒亞楠;間歇性外斜視分型與融合控制力的相關(guān)性研究[D];山東大學(xué);2015年

2 米靜;兒童間歇性外斜視手術(shù)年齡及術(shù)后視功能的臨床觀察[D];新疆醫(yī)科大學(xué);2014年

，

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