斜视手术中不同切口对患者泪膜功能与预后疗效的影响  

Effect of different surgical incisions during strabismus surgery on tear film function and patient prognosis

作　　者：代书英 王亚楠 徐红佳 孙卫锋 Dai Shuying;Wang Yanan;Xu Hongjia;Sun Weifeng(Strabismus and Pediatric Ophthalmology,Hebei Eye Hospital,the Ophthalmology of Hebei Key Laboratory,Hebei Eye Center,Xingtai,Hebei 054001,China)

机构地区：[1]河北省眼科医院,河北省眼科学重点实验室,河北省眼病治疗中心斜视与小儿眼科,河北邢台054001

出　　处：《临床眼科杂志》2020年第2期170-173,共4页Journal of Clinical Ophthalmology

摘　　要：目的探讨斜视手术中不同切口对患者泪膜功能与预后疗效的影响。方法选择我院手术治疗的109例斜视患者(2017年7月至2019年2月)进行前瞻性研究。按照随机数字表法划分为对照组51例,观察组58例,对照组术中作角膜缘梯形结膜瓣切口,观察组术中作改良Parks切口,比较两组的干眼症状评分、临床疗效、泪液分泌量、角膜荧光染色评分、泪膜破裂时间、术后并发症发生率、手术满意度。结果(1)组间临床疗效比较,观察组的总有效率高于对照组(P<0.05)。(2)两组治疗后的角膜荧光染色评分、干眼症状评分均较治疗前降低(P<0.05),两组治疗后的泪液分泌量均较治疗前增多(P<0.05),两组治疗后的泪膜破裂时间均较治疗前延长(P<0.05),而在治疗后,观察组的干眼症状评分、角膜荧光染色评分都低于对照组(P<0.05),其泪液分泌量、泪膜破裂时间多于对照组(均P<0.05)。(3)组间术后并发症总发生率比较,观察组低于对照组(P<0.05)。(4)组间手术满意度比较,观察组的总满意率高于对照组(P<0.05)。结论在斜视矫正手术中作改良Parks切口,可有效缓解患者的干眼症状,改善泪膜功能,还可减少术后并发症,有利于提高患者的临床疗效和手术满意度。Objective To investigate the effect of different surgical incision during strabismus surgery on tear film function and patient prognosis.Methods This study was a prospective study,109 strabismus patients who received surgical treatment in our hospital were recruited from July 2017 to February 2019.The patients were divided into the control group(51 cases)and observation group(58 cases)using a random number table.The trapezoid conjunctival flap incision was performed in the control group,and the modified Parks incision was performed in the observation group.The clinical efficacy,dry eye score,tear secretion,breakup time of tear film,corneal fluorescent staining score,surgical satisfaction and postoperative complications were compared between the two groups.Results The total effective rate in the observation group was higher than that of the control group(P<0.05).The dry eye symptom scores and corneal fluorescent staining scores in both groups reduced after the treatment(P<0.05),the amount of tear secretion as well as the breakup time of tear film increased in both groups after the treatment(both with P<0.05).While after the treatment,dry eye symptom scores and corneal fluorescent staining scores in the observation group were lower than that of the control group(P<0.05),and the amount of tear secretion and breakup time of tear film were larger than the control group(both with P<0.05).The total incidence of postoperative complications in the observation group was lower than the control group(P<0.05).The overall satisfaction rate in the observation group was higher than the control group(P<0.05).Conclusions The modified Parks incision during strabismus surgery can effectively relieve the dry eye symptom,improve tear film function,reduce postoperative complications,and improve the clinical efficacy and surgical satisfaction of the patients.

关 键 词：斜视 手术 泪膜功能 结膜切口 

分 类 号：R47[医药卫生—护理学]