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目的 :评价各种手术方法治疗上斜肌麻痹 (SOP)的疗效。方法 :11年来用 17种手术方法治疗SOP170例 ,对其中 160例进行平均 37个月的随访。结果 :160例 2 0 1次手术 ,平均每例 1.2 6次。代偿头位、上斜肌迟动 ,Ⅴ型斜视的消除和减轻分别为 92 / 99( 92 .9% ) ,147/ 152 ( 96.7% ) ,66/ 69( 95.7% )。手术前后检查同时视、融合、远立体视、近立体视 ,分别为 65/ 118( 55.1% ) ,95/ 12 0 ( 79.2 % ) ;34 / 10 0 ( 34 .0 % ) ,72 / 10 3( 69.9% ) ;18/ 93( 19.4 % ) ,58/ 91( 63.7% ) ;10 / 91( 11.0 % ) ,37/ 10 1( 36.6% ) (P均 <0 .0 0 1)。治愈 65例 ,好转 84例 ,无效 11例 ,总有效率 93.1%。结论 :SOP临床表现复杂 ,没有固定的手术模式 ,临床实践中需灵活选择符合具体病情的相应术式。
OBJECTIVE: To evaluate the efficacy of various surgeries in the treatment of upper oblique paralysis (SOP). Methods: In the past 11 years, 17 kinds of surgical methods were used to treat 170 cases of SOP, of which 160 cases were followed up for an average of 37 months. Results: 160 patients underwent 20 operations, an average of 1.2 6 times per case. The compensatory head position and delayed supraspinatus were 92/99 (92.9%), 147/152 (96.7%) and 66/69 (95.7%) respectively. The preoperative and postoperative examinations were 65/188 (55.1%), 95/120 (79.2%), 34/100 (34.0%), 72/103 (69.9%); 18/93 (19.4%), 58/91 (63.7%); 10/91 (11.0%); 37/101 (36.6%) (P <0.001). 65 cases were cured, 84 cases improved, 11 cases ineffective, the total effective rate was 93.1%. Conclusion: The clinical manifestation of SOP is complex and there is no fixed operation mode. In clinical practice, it is necessary to flexibly select the appropriate surgical procedure according to the specific condition.