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目的 探讨两种上斜肌加强手术即上斜肌折叠前徙术和上斜肌矢状移位术对外旋斜视的治疗效果.方法 对42例外伤所致的上斜肌麻痹,分别采用上斜肌折叠前徙术和上斜肌矢状移位术进行手术治疗,术前术后用同 视机“十”字画片检查九个诊断眼位的自觉斜视角,对两种术式的治疗效果进行对比分析.结果 42例患者 中,上斜肌折叠前徙术25例,术后第一眼位外旋斜视(2.23±1.40)°,下方注视(3.75±2.62)°;上斜肌矢状移 位术17例,术后第一眼位的外旋斜视(3.09±1.35)°,下方注视(5.31±3.01)°.两种上斜肌加强手术对第一 眼位和下方视野的外旋斜视的治疗,术前和术后比较均有显著差别(P＜0.05);两种手术对第一眼位外旋斜视 的矫正没有显著差别(P＞0.05),但是上斜肌矢状移位术对下方视野外旋斜视的矫正量较上斜肌折叠前徙术明 显(P＜0.05).结论 两种上斜肌手术对治疗第一眼位和下方视野的外旋斜视均有效;上斜肌折叠术能有效地 加强麻痹肌的功能,对垂直旋转斜视并存患者的作用较好;上斜肌矢状移位术对下方视野外旋斜视的治疗作用 更好,但术后远期眼位回退明显,术中应适当增加过矫量.“,”Objective To explore the therapeutic effects of two superior oblique muscle strengthening surgery, namely the superior oblique muscle fold forward surgery and the superior oblique sagittal transposition in the treatment of external rotation strabismus. Methods 42 cases of superior oblique muscle paralysis caused by trauma were treated with superior oblique muscle folding and superior oblique sagittal displacement, and nine visual angles were examined with the “+” pictures of the same visual machine before and after the operation, and the therapeutic effects of the two kinds of surgical methods were compared and analyzed. Results of the 42 patients, 25 cases of superior oblique muscle folding were performed, the first lateral rotation was (2. 23 ± 1.40)° inferior fixation (3. 75± 2. 62)°, 17 cases of superior oblique sagittal displacement, external rotation strabismus (3. 09 ± 1. 35)° at the first eye position, and inferior fixation (5. 31±3. 01)° below. There were significant differences between the two types of superior oblique surgery for the first and lower lateral vision (P＜0. 05), and there was no significant difference between the two operations on the orthodontic correction of the first eye (P ＞ 0. 05), but the correction of the sagittal displacement of the superior oblique muscle is more than that of the lower lateral vision. The migration of the oblique muscle was obvious (P＜0. 05). Conclusions The operation of two kinds of superior oblique muscles is effective for the treatment of the lateral lateral vision of the first eye position and the inferior visual field. The superior oblique muscle folding can effectively strengthen the function of the paralytic muscles, and the effect is better for the patients with vertical rotation strabismus coexistence. It is obvious that the over correction should be properly increased during the operation.