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目的观察单侧上斜肌麻痹不同术式的疗效。方法124例单侧上斜肌麻痹患者,据Knapp上斜肌麻痹手术方案,结合眼球运动及眼球旋转情况选择术式。垂直斜视角在5△～20△之间行单纯上斜肌折叠或单纯下斜肌后徙术;垂直斜视角>25△者,除上、下斜肌手术外,若麻痹眼为主眼,则同时选择对侧下直肌后徙术;若非麻痹眼为主眼,则同时选择同侧上直肌后徙术。若伴水平斜视,据常规手术量设计,同时予以矫正。结果垂直斜视治愈109例占87.90%,头消失107例占86.29%。其中单纯上斜肌折叠和单纯下斜肌后徙的垂直斜视治愈率分别为84.21%和92.31%,无统计学意义(x2=1.03,p>0.25);头位消失率分别为84.21和86.54%,无统计学意义(x2=0.062,p>0.75)。结论合理选择术式是矫正单侧上斜肌麻痹的关键。
Objective To observe the effect of unilateral supraspinatus paralysis with different surgical procedures. Methods 124 patients with unilateral supraspinal paralysis, according to Knapp supraspinatus paralysis surgery program, combined with eye movement and eye rotation situation selection operation. Vertical oblique angle in the 5 △ ~ 20 △ line between the simple upper oblique fold or simple inferior oblique muscle migration; vertical oblique angle> 25 △ who, except for the upper and lower oblique surgery, if the main eye paralyzed eye, then At the same time choose the opposite side of the rectus muscle surgery; if not the main eye paralysis, then choose the same side of the rectus muscle surgery. If with horizontal strabismus, according to the amount of conventional surgical design, at the same time to be corrected. Results 109 cases of vertical strabismus cure accounted for 87.90%, 107 cases of head disappear accounted for 86.29%. Among them, the vertical strabismus rates of simple superior oblique muscle fold and simple inferior oblique muscle retrofraction were 84.21% and 92.31% respectively, with no statistical significance (x2 = 1.03, p> 0.25); the disappearance rates of head position were 84.21 and 86.54% , No statistical significance (x2 = 0.062, p> 0.75). Conclusion The rational choice of surgical approach is the key to correct unilateral supraspinatus paralysis.