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1、新鲜羊膜在儿童调整显微斜视手术中的应用观谭叶辉曾广川廖武邱芳芳贾晓静广东省粤北人民医院眼科512026目的探讨新鲜羊膜在儿童调整显微斜视矫正手术中的临床应用疗效。方法采用新鲜羊膜移植联合直肌后徙缝线调整术治疗儿童共同性斜视18例36眼,术后随访均大于6个月。结果18例患儿术后均能配合眼位检查及眼位调整,调整后眼位基木满意;术后1周,眼位可调整12例24眼,可调整率为66.67%,眼位可调整量平均为5.30mm,术后5周,眼位可调整8例15眼,可调整率为41.67%,眼位可调整量平均为3.05mm;术后眼位可调整率及可调整量均明显
2、高于单纯直肌后徙缝线调整术。结论儿童调整显微斜视手术中应用新鲜羊膜安全有效,值得临床推广。关键词:羊膜;斜视矫正术;眼位调整ApplicationoffreshamnioticmembraneinforadjustablemicroscopicstrabismussurgeryinchildhoodTanYehui'ZengGuangchuan,NiaoWu,QiuFangfang,JiaXiaojing.DepartmentofOphthalmology,YueBeiPeople’sHospital,SouthHuiminRo
3、ad,Shaoguan,Guangdong,512026,China.AbstractObjectiveThisstudyistodiscusstheclinicalefficacyoffreshamnioticmembraneduringtheadjustablemicroscopicstrabismussurgeryinchildren.MethodsTransplantationsoffreshamnioticmembranecombinedwithrectusmusclerecessioncombinedadjustab
4、lesuturewereadoptedin18cases(36eyes)ofchildrenwithconcomitantstrabismus.AIIthepatientswerefollowed-upover6monthsaftertheadjustablemicroscopicstrabismussurgery.ResultsAllof18casesofchildrencancooperatewitheyepositionexaminationandadjustmentafterstrabismussurgery.Thead
5、justedeyepositionsweresatisfiedmainly.Atoneweekaftersurgery,Eyepositionof12cases(24eyes)canbeadjusted,withtheadjustmentratewas66.67%andtheaverageofadjustmentlengthsis5.30mm.Atfiveweeksaftersurgery,Eyepositionof8cases(15eyes)canbeadjusted,withtheadjustmentratewas41.67
6、%andtheaverageofadjustmentlengthsis3.05mm.Theadjustmentrateandtheadjustmentlengthswerehigherthanthatofrectusmusclerecessioncombinedadjustablesuture.ConclusionTheapplicationoffreshamnioticmembraneinadjustablemicroscopicsurgeryiseffectiveandsafeinthetreatmentofstrabism
7、usinchildrenandisworthspreadinginclinic.Keywordsamnioticmembrane;strabismussurgery;eyepositionadjustment斜视是儿童常见及多发眼病之一,儿童斜视早期手术治疗己经得到了公认,但儿童斜视矫正手术,因其特殊的生理特点,绝大多数均需在全身麻醉状态下进行,因术中无法配合眼位调整,儿童斜视术后预期结果的可靠性较低,多采用术后眼位调整方法来提高疗效,国内外人量研究证明缝线调整斜视矫正术是儿童斜[1】视矫正术后短时间内调整眼位的一种有效方法,但
8、传统的调整缝线术存在一些不可避免的问题,尤其是调整缝线与周围组织的粘连和瘢痕形成是长期闲扰眼科医生的难题。我们应用新鲜羊膜对传统的调整缝线手术做了改进,自2010年6月并将此项技术应用于儿童显微斜视手术中,取得了良好的临床效果,现将结果报告如下。资料与方法一、一