本文選題：斜視 + 分類�。� 參考：《吉林大學》2011年碩士論文

【摘要】：斜視是兒童發(fā)病率較高的眼部疾病之一,不僅影響美容,更重要的是影響正常視力的發(fā)育,可能導致弱視和立體視覺無法正常發(fā)育,還使兒童承受社會歧視的心理壓力,會給學習和生活以及今后的擇業(yè)帶來不良影響。近年來,我國兒童的斜視防治工作有了很大進展,許多眼科醫(yī)生和家長逐漸認識到斜視給兒童帶來的嚴重后果。 目的:了解我院兒童斜視的類型分布、兒童斜視手術(shù)時機的選擇等,以期指導臨床工作。另外分析斜視患者手術(shù)后立體視恢覺復情況,討論其影響因素,為斜視患者提供最佳的治療方案,提高治療效果,提供理論依據(jù)。 方法:2010年3月到2011年5月期間吉林大學第二醫(yī)院斜視與小兒眼病科收治的兒童斜視患者(患者年齡均小于等于14歲,行斜視矯正術(shù))病歷作回顧性研究,分析其斜視類型分布、發(fā)現(xiàn)斜視年齡分布、手術(shù)年齡分布、臨床表現(xiàn)等情況。對按時回院檢查立體視覺的兒童做立體視覺恢復情況及相關(guān)危險因素分析。 結(jié)果:①在此期間,我院眼科中心共收治505名14歲及以下兒童斜視患者,并于全麻或局麻下行斜視矯正術(shù)。所有病人中,共同性內(nèi)斜視患者為78例,占15.5%,共同性外斜視患者318例,占63.0%,麻痹性斜視患者78例,占15.5%。其它為特殊類型斜視,包括DVD(1.0%)、Duane眼球后退綜合征(0.6%)、V型內(nèi)斜視、V型外斜視以及A型斜視等共31例(6.0%)。其中年齡最大者14歲,最小者16個月。②不同年齡分層中各種斜視類型的分布差異經(jīng)檢驗具有統(tǒng)計學意義(χ2=29.02,P0.05)。另外各種斜視類型在有無家族史分組中、是否伴發(fā)弱視分組中、能否控制正位分組中、術(shù)前立體視覺正常與否分組中及不同發(fā)現(xiàn)斜視年齡分組中分布均有差異,且差異有統(tǒng)計學意義(P0.05)。③通過單因素分析和多因素Logistic回歸分析,發(fā)現(xiàn)斜視年齡、病程、能否控制正位及術(shù)后立體視覺訓練是影響術(shù)后立體視覺恢復的因素。 結(jié)論:①兒童斜視手術(shù)患者中共同性外斜視比例高于共同性內(nèi)斜視。②不同類型斜視的年齡構(gòu)成、斜視發(fā)現(xiàn)年齡、家族史、控制正位情況、弱視發(fā)生情況、術(shù)前立體視覺情況等分布不同。③通過單因素分析和多因素Logistic回歸分析,發(fā)現(xiàn)斜視年齡、病程、能否控制正位及術(shù)后立體視覺訓練是影響術(shù)后立體視覺恢復的因素。
[Abstract]:Strabismus is one of the eye diseases with high incidence in children. It not only affects beauty, but also affects the development of normal vision, which may lead to amblyopia and stereoscopic vision, and make children suffer psychological pressure of social discrimination. Will have a negative impact on study and life, as well as future career choices. In recent years, great progress has been made in the prevention and treatment of strabismus among children in China. Many ophthalmologists and parents have come to realize the serious consequences of strabismus on children. Objective: to investigate the distribution of strabismus in children and the choice of surgical opportunity for children strabismus in order to guide the clinical work. In addition, the situation of stereoscopic vision recovery after operation in strabismus patients was analyzed, and the influencing factors were discussed, so as to provide the best treatment plan for strabismus patients, to improve the therapeutic effect and to provide theoretical basis for the treatment of strabismus patients. Methods: from March 2010 to May 2011, the medical records of children with strabismus and infantile ophthalmopathy in the second Hospital of Jilin University were retrospectively studied and their strabismus types were analyzed. The age distribution of strabismus, the age distribution of operation and the clinical manifestation were found. The recovery of stereoscopic vision and related risk factors were analyzed in children who returned to hospital on time. Results during this period, 505 children with strabismus under 14 years old were treated in the ophthalmic center of our hospital, and the orthopedics was performed under general anesthesia or local anesthesia. Among all the patients, 78 cases were concomitant esotropia, 318 cases were concomitant exotropia, 78 cases were paralytic strabismus. Other types of strabismus included DVD (1.0%) Duane's receding syndrome (0.6%), V-esotropia, V-type exotropia and type A strabismus in 31 cases (6.0%). Among them, the oldest was 14 years old, and the youngest was 16 months. 2 the distribution difference of different strabismus types in different age stratification was statistically significant (蠂 2 / 29.02 P 0.05). In addition, there were differences in the distribution of strabismus in the groups with or without family history, whether accompanied with amblyopia, whether or not to control the positive position, whether the stereovision was normal or not before operation and in the age groups with different found strabismus. The difference was statistically significant (P0.05). By univariate analysis and multivariate logistic regression analysis, it was found that strabismus age, course of disease, control of orthopedics and stereoscopic training after operation were the factors affecting the recovery of stereopsis. Conclusion the proportion of concomitant exotropia in children with strabismus of 1: 1 is higher than that in concomitant esotropia .2 different types of strabismus. The age, family history, control of positive position and amblyopia are found in strabismus. By univariate analysis and multivariate logistic regression analysis, it was found that age of strabismus, course of disease, control of orthopedics and stereoscopic training after operation were the factors affecting the recovery of stereopsis.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R779.6

【參考文獻】

相關(guān)期刊論文 前10條

1 鄒欣;共同性斜視術(shù)后的立體視覺[J];大連醫(yī)科大學學報;2004年02期

2 王夏虹,皮敏石,陳集玲;共同性外斜視術(shù)后雙眼視功能及眼位臨床觀察(附97例分析)[J];福建醫(yī)藥雜志;2005年04期

3 范麗英;張芳;候立杰;徐肅仲;;共同性斜視立體視覺的臨床檢測與分析[J];國際眼科雜志;2007年02期

4 李恒,曾小平;共同性斜視術(shù)后立體視功能的重建[J];國際眼科雜志;2008年02期

5 郭雷;才娜;韓屹;;兒童間歇性外斜視手術(shù)前后近立體視功能的觀察[J];國際眼科雜志;2011年06期

6 劉其生,王輝,文道源,蔣貽平;兒童斜視矯正術(shù)與視功能恢復(附6例報告)[J];贛南醫(yī)學院學報;2002年04期

7 王競;兒童斜視不容忽視[J];今日科技;1998年07期

8 王鷺沙;楊林靜;;屈光不正性弱視治愈后立體視覺訓練療效的初步觀察[J];臨床眼科雜志;2006年05期

9 徐新華;間歇性外斜視手術(shù)治療探討[J];臨床眼科雜志;1999年04期

10 Fawcett S.L.;Birch E.E.;王大江;;關(guān)于人立體視敏感性臨界期的研究[J];世界核心醫(yī)學期刊文摘.眼科學分冊;2005年07期

相關(guān)重要報紙文章 前2條

1 首都醫(yī)科大學附屬北京友誼醫(yī)院 吳靜;[N];家庭醫(yī)生報;2003年

2 蒲昭和;[N];醫(yī)藥經(jīng)濟報;2001年

相關(guān)碩士學位論文 前3條

1 曾仁攀;共同性斜視手術(shù)前后視覺三級功能的臨床觀察[D];成都中醫(yī)藥大學;2008年

2 楊倩;間歇性外斜視手術(shù)療效相關(guān)因素的研究[D];河北醫(yī)科大學;2009年

3 王曦瑯;先天性上斜肌麻痹患者術(shù)后雙眼視覺的重建[D];中南大學;2008年

，

本文編號：2116261