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[目的]研究压抑疗法与遮盖法治疗对儿童单眼中重度弱视的临床疗效和对立体视重建的影响,并对两种方法的依从性进行比较。[方法]选取254例3～10岁单眼中重度弱视儿童,随机分成2组,126例为压抑组,弱视眼过矫+2.50D,优势眼作全部屈光矫正或调整优势眼屈光度,使优势眼戴镜视力低于弱视眼,隔天晚上涂1%阿托品眼膏于优势眼下睑结膜囊内,施行近压抑;128例为遮盖组,弱视眼配适矫镜,优势眼每天遮盖6h或以上。在9个月时从视力恢复和Titmus立体视重建两方面进行疗效比较,并比较患儿及家长对两种方法的依从性。[结果]压抑组疗效的总有效率为84.3%;遮盖组为85.1%;两者差异无统计学意义(P=0.8764,P﹥0.05)。Titmus立体视重建压抑组为37例,有效率为72.5%;遮盖组为29例,有效率为53.7%;两者差异有统计学意义(P=0.0458,P﹤0.05)。两组的依从性分别为74.8%和57.9%,差异有统计学意义(P=0.0138,P﹤0.05)。[结论]本研究显示压抑疗法与遮盖法在治疗儿童单眼中重度弱视具有同等的临床疗效;对立体视重建压抑疗法优于遮盖法;依从性压抑疗法优于遮盖法。
[Objective] To investigate the clinical effects of suppression therapy and masking treatment on severe amblyopia in children’s monocular and stereopsis reconstruction, and to compare the compliance of the two methods. [Method] One hundred and twenty-five children (3 ~ 10 years old) with severe amblyopia in monocular were randomly divided into 2 groups, 126 patients were repressed group, 2.50D was corrected by amblyopia, all eyes were corrected by refractive power, Eye wear glasses lower than the amblyopic eye, night 1% coated with atropine eye ointment in the superior conjunctiva within the eye, the implementation of nearly suppressed; 128 cases for the cover group, amblyopia with correction lens, the dominant eye cover 6h or more every day . The efficacy was compared at nine months from both visual acuity restoration and Titmus stereopsis reconstruction, and comparisons between children and parents regarding adherence to the two methods were made. [Results] The total effective rate was 84.3% in the suppression group and 85.1% in the covered group. There was no significant difference between the two groups (P = 0.8764, P> 0.05). Titmus stereopsis reconstruction group was 37 cases, the effective rate was 72.5%; covered group was 29 cases, the effective rate was 53.7%; the difference between the two groups was statistically significant (P = 0.0458, P <0.05). The compliance of the two groups was 74.8% and 57.9%, respectively, with significant difference (P = 0.0138, P <0.05). [Conclusion] This study shows that repressive therapy and obturation have equal clinical efficacy in treating children with severe amblyopia in monocular; stereopsis reconstruction is superior to obscuring; stereotactic depressive therapy is superior to obscuring.