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目的探讨调整缝线技术在儿童间歇性外斜视手术的应用及儿童间歇性外斜视手术设计的特点。方法回顾性分析70例使用调整缝线技术的间歇性外斜视患儿,按术后眼位是否矫正满意(-8△～+8△)将患者分为矫正满意组(46例)和不满意组(24例)。比较二组患者的发病时间、手术年龄、手术是否涉及下斜肌和内直肌等。结果矫正不满意组患者中,欠矫者1例,过矫者23例。比较两组患者的发病时间、手术年龄、性别构成、手术是否涉及下斜肌减弱,差异没有统计学意义(P>0.05)。比较两组患者手术是否涉及内直肌加强,差异有统计学意义(P<0.05)。结论儿童间歇性外斜视的手术设计应充分考虑患者的双眼视功能状况,手术涉及内直肌加强时,应适当减少手术量。调整缝线技术应用于儿童间歇性外斜视手术有其独到的优势,不仅可使手术设计更加充分,保证术后早期眼位矫正的满意,更可提供追求远期效果的手段。
Objective To investigate the application of suture adjustment in children with intermittent exotropia and the characteristics of intermittent exotropia in children. Methods A retrospective analysis of 70 patients with intermittent exotropia using modified suture technique was divided into satisfactory satisfaction group (n = 46) and unsatisfactory according to whether the ocular position correction (-8 △ ~ + 8 △) Group (24 cases). Comparing the onset time of the two groups of patients, the age of surgery, surgical involvement of inferior oblique and medial rectus and so on. Results unsatisfactory group of patients, undercorrection in 1 case, 23 cases of overcorrection. The onset time, the age of surgery, the sex composition and the decrease of inferior oblique muscle involved in the two groups were not statistically significant (P> 0.05). Comparisons between the two groups of patients whether the involvement of medial rectus muscle strengthening, the difference was statistically significant (P <0.05). Conclusion The surgical design of intermittent exotropia in children should take full account of binocular vision of patients with functional status, surgery involving the rectus muscle strengthening should be appropriate to reduce the amount of surgery. Adjustment of suture technology used in children with intermittent exotropia surgery has its own unique advantages, not only to make the surgery more fully designed to ensure the satisfaction of early postoperative eye correction, but also to provide the means to pursue long-term results.