角膜屈光手术前用药时间对泪膜稳定性的影响  

Effect of different medication time prior to corneal refractive surgery on tear film stability

作　　者：陈开建[1] 余婷[1] 潘娇 刘李娜[1] 郎敏[1] 白继[1] Chen Kaijian;Yu Ting;Pan Jiao;Liu Lina;Lang Min;Bai Ji(Department of Ophthalmology,Institute of Field Surgery,Dapiag Hospital,Army Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院野战外科研究所眼科,重庆400042

出　　处：《中华眼科杂志》2018年第10期744-747,共4页Chinese Journal of Ophthalmology

摘　　要：目的探讨角膜屈光手术前不同用药时间对泪膜稳定性的影响。方法前瞻性队列研究。收集2017年4至6月在陆军军医大学大坪医院野战外科研究所眼科拟行准分子角膜屈光手术且眼表疾病指标量表评分正常的近视眼患者60例（60只眼），年龄（24．2±5．1）岁，其中男性38例（63．3％），女性22例（37．7％）。采用随机数字法分为用药1d组30例（30只眼）和用药3d组30例（30只眼），分布给予相应的片j药方案。所有患者分别于术前检查时和手术日行Keratograph5M眼表综合仪检查，记录首次泪膜破裂时间（FBUT）、平均泪膜破裂时间（AVBUT）及干眼分级评分。采用独立样本￡检验比较两组问FBUT和AVBUI的差异，配对￡检验比较组内术前检查与手术日FBUT和AVBUT的差异，卡方检验比较两组间性别分布及干眼分级分布的差异。结果术前检查时用药1d纽与用药3d组FBUT分别为（10．89±5．19）S与（10．88±6．82）S，AVBUT分别为（16．24±3．62）S与（16．21±4．74）S；手术日用药1d组与用药3d组FBUT分别为（10．65±6．03）S与（8．14±5．75）S，AVBUT分别为（15．14±5．30）S与（12．86±5．92）s，两组问差异均无统计学意义（t=O．01，0．02，1．47，1．44；P〉O．05）。但在刚药3d组中，手术日AVBUT较术前检查减小，差异具有统计学意义（t=2．31，P〈0．05）。两组术前检查和手术日干眼分级分布差异均无统计学意义（X2：0．07，3．36；P〉O．05）。结论角膜屈光手术前用药1d与用药3d泪膜稳定性相近，但是对于术前存在无症状而泪膜破裂时间异常的患者应注意同手术期的术前合理用药。Objective To investigate the effect of different medication time prior to corneal refractive surgery on tear film stability.Methods Prospective cohort study. A total of 60 patients （60 eyes）, including 38 males （63.3%） and 22 females （37.7%） with an average age of （24.2±5.1） years （form 18 to 37 years）, who had planned for corneal refractive surgery, with normal ocular surface disease index score were included in this study, The patients were divided into ld group （medication of l day, 30 eyes） and 3d group （medication of 3 days, 30 eyes） randomly. The first tear break up time （FBUT）, the average tear break up time （AVBUT） and the dry eye grade score were recoMed on the examination day and the operation day with Keratograph 5M. The difference of FBUT and AVBUI between the two groups was compared with the independent sample t test. The difference of FBUT and AVBUT between the examination day and the operation day was compared with the paired t test. The difference of the dry eye classification between the two groups was compared using chi-square test. Results The FBUT and AVBUT of ld group and 3d group were （10.89 ± 5.19）s and （10.88 ± 6,82）s, （16.24 ± 3.62）s and （16.21 ±4.74）s respectively in preoperative examination, and （10.65±.03）s and （8.14±5.75）s, （15.14±5.30）s and （12.86±5.92）s respectively in operation day. There was no significant difference in FBUT and AVBUT between the two groups （t=0,O1, 1,47, 0.02, 1.44; P〉0.05）. However, in the 3d group, the AVBUT of operation day decreased as compared with that of the examination day, and the difference was statistically significant （t=2.31, P〈0.05）. There was no significant difference in the distribution of dry eye classification between the two groups （X2=0.07, 3.36; P〉 0.05）. Conclusion Both of medication of 1 day and medication of 3 days prior to corneal refractive surgerycan provide a similar tear film stability, however more attention should be paid to the medication

关 键 词：术前用药法 屈光外科手术 眼泪 时间 

分 类 号：R779.6[医药卫生—眼科]