综合疗法治疗儿童弱视821例疗效分析

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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。 Objective: To investigate the clinical curative effect of combined therapy on amblyopia in children, and give the evaluation. Methods: A total of 821 children (1510 eyes) with amblyopia were treated comprehensively, and the follow-up of their efficacy was over 3 years. Results: The cure rate was 44.90%, 46.82% improvement, with a total effective rate of 91.72% and no effective rate of 8.28%. The ametropia amblyopia cure rate was 51.04%, significantly higher than anisometropia, strabismic amblyopia and form-deprivation amblyopia; mild amblyopia cure rate was 86.93%, significantly higher than moderate and severe amblyopia; under the age of 3 and 3 ~ 8 years old cure rate was significantly higher than 11 ~ 14 years old and 15 years old; center fixation recovery rate was 46.83%, significantly higher than the center of 19.63%; low diopter group (spherical ≤3.00D, cylinder≤1.00 D) The cure rate was 66.13%, which was significantly higher than that of moderate (spherical 3.25-4.75 D, cylindrical 1.25-1.50 D) 28.88% and height (spherical ≥5.00 D, cylindrical ≥1.75 D) 18.93%. Refractive type to pure hypermetropia cure rate was 54.31%, significantly higher than other refractive types. Conclusion: The therapeutic effect of amblyopia in children is closely related to the type of asthenia, degree, nature of gaze, the level of refraction, the type of refraction and the age of treatment. The treatment of amblyopia in children can improve the cure rate. Compound moxibustion Atropine mydriasis optometry the same effect. Advocate not cover when going to school, covering 35 h every week, parents and the visually impaired children to arrange their own cover time, thereby enhancing the compliance and cure rate.
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