摘要
Abstract
Objective To explore the effects of horizontal muscle strengthening and weakening surgery combined with botulinum toxin A on the treatment of pediatric strabismus and the stereopsis and tear film function in children.Methods 50 children with strabismus treated in the author's hospital from June 2020 to June 2022 were prospectively selected as the study subjects.They were divided into the study group and the control group according to the random number table,with 25 cases in each group.The control group received horizontal muscle strengthening and weakening surgery for treatment,while the research group received combined injection of Botulinum Toxin A(BTX-A)into the extraocular muscles on the basis of the control group.Check and record the curative effect(cure,basic cure,undercorrection rate),Binocular vision function,near stereo vision function,tear film function of the children before and after treatment,and the complications within 1 year after treatment.Results The total effective rate of the study group's treatment was 92.00%,which was much higher than the improved total effective rate of the control group,which was 66.67%.There is a statistical difference between groups in comparison(χ2=4.838,P＜0.05).Two groups of children had grade Ⅰ simultaneous visual function before treatment.Level Ⅱ fusion function;There was no significant difference in grade Ⅲ far stereoscopic vision function.At the 6th month after treatment,the number of children in the study group with grade Ⅱ function(fusion vision)and grade Ⅲ function(distant stereopsis)was significantly higher than that in the control group,and the difference between the groups was statistically significant(P＜0.05).There was no statistically significant difference in the proportion of children with near stereoscopic visual function between the two groups before treatment(P＞0.05).At the 6th month after treatment,the number of children with near stereoscopic vision function in both groups increased,and the proportion of children with near stereoscopic vision function in the study group(20/25)was significantly higher than that in the control group(12/24).The difference between the groups was statistically significant(P＜0.05).There was no statistically significant difference in the Schirmer test(SLT),tear film rupture time(BUT),and corneal fluorescence stain(CFS)between the two groups of children before treatment(P＞0.05).At the sixth month after treatment,the SLY of the study group was significantly higher than that of the control group(P＜0.05),and the BUT value was not significantly different from the control group.There was no statistical difference between the groups(P＞0.05),while the CFS was significantly lower than that of the control group(P＜0.05).The incidence of postoperative complications in the study group and the control group was(54.16%vs.28.00%),with a statistically significant difference(χ2=3.934,P=0.047).Conclusion The combination of horizontal muscle strengthening and weakening surgery with type A botulinum toxin micro injection has a significant effect on the treatment of pediatric strabismus,which helps to restore visual function and near stereoscopic visual function in children.It has less damage to tear film function and higher safety,and can be promoted and applied in clinical treatment of pediatric strabismus.关键词
A型肉毒毒素/水平肌加强减弱术/小儿斜视/立体视功能/泪膜功能Key words
type A botulinum toxin/horizontal muscle strengthening and weakening surgery/pediatric strabismus/stereoscopic function/tear film function分类
医药卫生
