超声乳化吸出术后应用甾体类与非甾体类消炎药对泪膜及角膜知觉影响  

The effects of NSAIDs and steroid on tear film and corneal sensitivity after phacoemulsification

作　　者：滕贺[1] 张劲松[1] 

机构地区：[1]中国医科大学附属第一医院眼科,沈阳110001

出　　处：《中国实用眼科杂志》2005年第2期130-133,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的　观察甾体类与非甾体类消炎药 (NSAIDs)对超声乳化白内障吸出术后泪膜及角膜知觉的不同影响。方法　随机选取 5 8例 (6 6眼 )行超声乳化白内障吸出术的老年性白内障患者 ,随机分为 2组 ,组A :2 9例 (33眼 ) ,术后给予妥布霉素 +地塞米松滴眼液。组B :2 9例 (33眼 ) ,术后给予妥布霉素 +普拉洛芬滴眼液。分别于术前、术后 1、 3、 7、 14、 30及 90天对随访患者依次行Schirmer试验、非侵犯性泪膜破裂时间 (non -invasivebreakuptimeNIBUT)、上方及中央角膜知觉和患者主观干眼感觉评分调查。结果　术后各时间段两组患者Schirmer值比较、主观干眼感觉评分值比较差异无统计学意义 (P >0 0 5 )。术后 3天、 7天两组的NIBUT (t =- 2 35、 - 2 4 1;P =0 0 3、 0 0 3) ,上方角膜知觉 (t =- 2 19、 - 2 2 6 ;P =0 0 4、 0 0 4 ) ,中央角膜知觉 (t =- 2 2 5、- 2 4 1;P =0 0 4、 0 0 3)的差异有显著统计学意义 ,P均小于 0 0 5。术后 14天后差异无显著统计学意义 (P >0 0 5 )。结论　超声乳化白内障吸出术后早期 ,NSAIDs对泪膜稳定性及上方和中央角膜知觉恢复的影响大于甾体类消炎药。即应用NSAIDs患者的泪膜更不稳定、角膜知觉恢复慢于甾体类消炎药组。Objective To evaluate the effect of NSAIDs and steroid on tear film and corneal sensitivity after phacoemulsification.Methods 66 eyes of 58 consecutive patients with age-related cataract underwent phacomulsification were divided into 2 groups randomly.The first group was given 0 3% tobramycin +0 1% dexamethason after surgry.The second group was given 0 3% tobramycin +0 1% pranoprofen after surgry.Both of the two groups were examined Schirmer test,non-invasive break up time(NIBUT),corneal sensitivity and subjective score for dryness before and after surgery(1day,3days,7days,14days,1month,3months).Results As for Schirmer test and subjective score for dryness,there was no significant difference between the two groups at any time spot after surgry.At 3 days,7 days postoperatively,there were significant differences of NIBUT(t=-2 35、-2 41; P =0 03、0 03),upper corneal sensitivity(t=-2 19、-2 26; P =0 04、0 04)and central corneal sensitivity(t=-2 25、-2 41; P =0 04、0 03)between the two groups.And the differences were not significant after 2 weeks( P >0 05).Conclusions At the early stage of postoperation,NSAIDs has more effet on the recovery of tear film stability and corneal sensitivity than steroid.The tear film stability of NSAIDs group was more unstable,and the recovery of corneal sensitivity was slower.

关 键 词：角膜知觉 术后 患者 泪膜 NSAID 白内障吸出术 非甾体类消炎药 目的观 结论 评分值 

分 类 号：R779.63[医药卫生—眼科] R776.1[医药卫生—临床医学]