摘要目的:观察鼻内镜鼻窦手术所致内直肌损伤的临床特征和治疗效果。方法:回顾性分析郑州大学第一附属医院2016年10月至2019年5月鼻内镜鼻窦手术所致内直肌损伤的15例临床资料，根据牵引试验、MRI及CT检查结果判断内直肌损伤程度。患者分为两组：内直肌部分离断者6例(A组)，内直肌完全离断者9例(B组)。分析对比两组效果。结果:A组治疗前后斜视度分别为(55.83±12.81)PD和(6.67±2.58)PD( t＝9.214， P＝0.000)；B组治疗前后斜视度分别为(90.55±8.08)PD和(17.78±5.07)PD( t＝22.891， P＝0.000)。A组治疗前后内转受限程度分级分别为(2.50±0.55)级和(1.00±0.00)级( t＝6.708， P＝0.000)；B组治疗前后内转受限程度分级分别为(4.00±0.00)级和(2.11±0.33)级( t＝17.000， P＝0.000)。治疗后6例正前方注视复视消失，其余9例复视均改善。 结论:鼻内镜鼻窦手术所致内直肌损伤，以影像学检查结果及牵引试验指导设计个性化治疗方案，可取得较好的治疗效果。

abstractsObjective:To observe the clinical characteristics and efficacy of medial rectus muscle injury induced by nasal endoscopic sinus surgery.Methods:The clinical data of 15 cases with medial rectus muscle injury induced by nasal endoscopic sinus surgery from Oct. 2016 to May 2019 in The First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. The injury degree of medial rectus muscle was estimated according to the results of pull test, MRI and CT. These patients were divided into group A, 6 cases with partial dissociation of the medial rectus muscle, and group B, 9 cases with complete dissociation of the medial rectus muscle. The efficacy were analyzed and compared between the two groups.Results:The exotropia degree before and after treatment in group A was (55.83±12.81) PD and (6.67±2.58) PD ( t=9.214, P=0.000). The exotropia degree before and after treatment in group B was (90.55±8.08)PD and (17.78±5.07)PD( t=22.891, P=0.000). The degree grading of restriction of internal rotation before and after treatment in group A was (2.50±0.55) grades and (1.00±0.00) grades ( t=6.708, P=0.000). The degree grading of restriction of internal rotation before and after treatment in group B was (4.00±0.00) grades and (2.11±0.33) grades ( t=17.000, P=0.000). The symptoms of diplopia were gone in 6 cases and improved in 9 cases. Conclusion:The results of imaging examination and pull test can be used to guide and design the individuated treatment plan for medial rectus muscle injury induced by nasal endoscopic sinus surgery, and can obtain good efficacy.