阿托品在儿童验光时的应用  

Cycloplegia by atropine in children's optometry

作　　者：朱伟林[1] 尹忠贵[1] 李赵霞[1] 吴洁[1] 

机构地区：[1]上海市浦东新区人民医院眼科,201200

出　　处：《中国斜视与小儿眼科杂志》2006年第4期173-175,共3页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的观察不同年龄及不同静态屈光度儿童使用阿托品前后屈光度的变化,探讨阿托品散瞳验光的适应证。方法对66名3～14岁儿童1%阿托品眼药点眼,每晚睡前1次,共7次,用药前后分别进行电脑验光(CanonRK-5电脑验光仪)。检查对象按年龄分为:3～6、7～10及11～14岁组共3组,每个年龄组再按静态屈光分为4组:+3.00D以上远视、+0.25～+2.75D、0～-2.75D及-3.00以上近视组。对各组使用阿托品前后屈光度行卡方分析。结果(1)球镜度变化:使用阿托品前后屈光度,各组间统计均有显著性差异(P<0.01),屈光度差异表现为年龄越小、远视屈光度越高其前后屈光度差值越大,变化范围从0.11±0.09～1.60±0.19;(2)散光度数及轴向变化:同样方法分析使用阿托品前后散光度及轴向变化,结果显示,各组间统计均无显著性差异(P>0.05)。结论儿童诊断性验光必须使用阿托品。以后光学矫正为目的时,所有远视儿童必须使用阿托品;近视儿童中,7岁以前儿童必须使用阿托品,10岁以上的近视儿童可酌情选择其他睫状肌麻痹剂。Objective To observe the refraction change before and after cycloplegia by atropine in children with different ages and different static refraction. To explore the indication of cycloplegic refaction by airopine in optometry. Method 66 children in age of 3 - 14 years old were examined their refraction by auto ref-keratometer before and after cycloplegic （1%atropin eye ointment was used every night in 7days）. They were divided by 3 groups with different age ： 3 - 6, 7 10, and 11 - 14 years old group. Each group was divided into 4 parts by their static refraction （according to the optometry after cycloplegic）：hypermetropia above ＋3.00D, ＋0.25D-＋2.75D, 0 - -2.75D and myopia above -3.00D. The refraction of different groups was statistical analyzed. Result 1. Sphere change： for the refraction before and after cycloplegic, there was significant difference between groups （P 〈 0.01）. The younger the child was, the higher the hypennetropia diopter was, and the larger the refraction difference was. The range was between 0.11 ±0.09 - 1.60±0.19. 2. Astigmatism and axial change： the same method was used in analyzing the astigmatism and axial change, and the result showed that there was no significant difference between the groups （P 〉 0.05）. Conclusion All the hypermetropia children must use atropine. In myopia children, those younger than 7 years old must use atropine and those older than 10 years old could make some other choice of cycloplegic.

关 键 词：儿童 阿托品 验光 

分 类 号：R778.2[医药卫生—眼科]