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目的总结并探讨下转配偶肌功能不全的临床特点。设计回顾性病例系列。研究对象北京同仁医院69例大角度水平斜视伴有上斜肌亢进及下直肌肌力弱者。方法通过记录患者的发病年龄、检查患者的视力、眼位、眼球运动,对患者的临床特点进行分析。主要指标患者的发病年龄,视力,水平与垂直眼位,眼球运动,双眼视功能等。结果本类型斜视发病年龄早,≤2岁发病者44例(63.77%)。双眼视力良好,视力或矫正视力正常者65例(94.2%)。双眼视功能不佳,69例患者均未查到双眼融合功能及立体视觉。多与大角度外斜视合并发生,水平斜视伴有A征者占68.11%。第一眼位可表现有交替或一眼上斜视,第二眼位表现内转眼位低,外转眼位高,在双眼左下转和右下转垂直分离更显著。双眼球水平运动表现双眼上斜肌亢进,双眼下直肌肌力弱或一眼上斜肌亢进,另一眼下直肌肌力弱。治疗以矫正A型水平斜视为主。结论下转配偶肌功能不全有明显区别于其他斜视类型的临床表现及鉴别诊断要点,有独立的手术治疗原则。因此可以作为独立命名的一类斜视。
Objective To summarize and discuss the clinical features of splenic myogenic dysfunction. Design retrospective case series. Research object Beijing Tongren Hospital, 69 cases of high angle strabismus with suprakeletal hyperthyroidism and lower rectus muscle weakness. Methods The patient’s clinical features were analyzed by recording the age of onset, examining the patient’s vision, eye position and eye movement. The main indicators of the patient’s age of onset, visual acuity, horizontal and vertical eye position, eye movement, binocular vision and so on. Results The incidence of strabismus was earlier in this type, 44 (63.77%) were less than 2 years old. Good binocular vision, visual acuity or normal vision correction in 65 cases (94.2%). Binocular vision dysfunction, 69 patients were not found in both eyes fusion function and stereoscopic vision. More with large-angle exotropia occurred, strabismus associated with A sign accounted for 68.11%. The first eye position can be expressed as alternating or one strabismus, the second eye position within the turn to show low eye movements outside the eye position high in the left eye and right lower left turn vertical separation more significant. Binocular lateral movement of the performance of upper oblique hyperactivity, binocular muscle weakness or a lower oblique hyperthyroidism, the other eye muscle weakness. Treatment to correct type A-level strabismus-based. Conclusions Downward spouse muscle dysfunction is obviously different from other strabismus type of clinical manifestations and differential diagnosis points, there is an independent principle of surgical treatment. So can be used as a type of strabismus named independently.