三种不同白内障超声乳化术切口治疗合并2型糖尿病白内障患者的临床疗效比较  

Comparison of clinical efficacy of three different cataract incision phacoemulsification for cataract patients with type 2 diabetes mellitus

作　　者：苏琪[1] 张新[1] 赵燕[1] 程玉瑛[1] 宋耕[1] 张骞颖 Su Qi;Zhang Xin;Zhao Yan;Cheng Yuying;Song Geng;Zhang Qianying(Department of Ophthalmology,the First Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第一医院眼科,石家庄050000

出　　处：《中国医师杂志》2021年第7期1030-1033,1038,共5页Journal of Chinese Physician

基　　金：河北省医学科学研究重点课题计划(20180206)。

摘　　要：目的对比研究三种不同白内障超声乳化术切口治疗合并2型糖尿病白内障患者的临床疗效。方法回顾性分析2018年1月至2019年6月在河北医科大学第-医院行白内障摘除联合人工晶状体植入术的120例(198眼)合并2型糖尿病白内障患者,根据手术切口将患者分为三组,采用角巩膜缘切口为A组(40例,72眼),上方透明角膜切口为B组(40例,66眼),颞侧透明角膜切口为C组(40例,60眼),分别比较三组治疗前后不同时间段角膜知觉、干眼症状、基础泪液分泌试验(Slt)、泪膜破裂时间(BUT)、角膜荧光素染色(FL)及并发症。结果B组与C组于术后1、7、30d角膜知觉均低于A组(P<0.05);C组于术后1、7、30 d干眼症状评分值高于A组及B组(P<0.05),B组于术后1、7 d干眼症状评分值高于A组(P<0.05);C组于术后1、7、30 d Sit值低于A组(P<0.05),B组于术后1、7、30 d值低于A组及C组(P<0.05);C组于术后1、7 d BUT值均低于A组(P<0.05),B组于术后1、7、30d BUT值均低于A组及C组(P<0.05);治疗后1、7、30、90d A组与C组FL值与治疗前相比,差异无统计学意义(P>0.05),B组FL值于术后30 d恢复至治疗前水平,B组于术后1、7 d FL值均高于A组及C组(P<0.05);三组并发症发生率比较差异有统计学意义(P>0.05)。结论角巩膜缘切口可减少对泪液分泌的影响,维持泪膜稳定,更适用于合并2型糖尿病白内障患者,值得临床上进一步推广。Objective To compare and study the clinical efficacy of three different phacoemulsification incisions for cataract patients with type 2 diabetes mellitus.Methods A retrospective analysis was performed in 120 patients(198 eyes)with type 2 diabetes cataract who underwent cataract extraction and intraocular lens implantation from January 2018 to June 2019 in the First hospital of Hebei Medical University.According to the surgical incision,the patients were divided into three groups:A group(the cornea scleral marginal incision,40 cases,72 eyes),B group(the clear corneal incision at the top,40 cases,66 eyes),C group(underwent temporal clear corneal incision,40 cases,60 eyes).The corneal perception,dry eye symptoms,basic tear secretion test(Sit),tear film rupture time(BUT),corneal fluorescein staining(FL)and complications were compared among the three groups before and after treatment.Results The corneal perception of B group and C group was lower than that of A group on 1 d,7 d and 30 d after operation(P<0.05);The scores of dry eye symptoms in C group were higher than those in A group and B group on 1 d,7(I and 30 d after operation(f<0.05),and the scores of dry eye symptoms in B group were higher than those in A group on 1 d and 7 d after operation(P<0.05);The Sit value of C group was lower than that of A group on 1 d,7 d and 30 d after operation(P<0.05),and that of B group was lower than that of A group and group C on 1 d,7 d and 30 d after operation(P<0.05);The BUT value of C group was lower than that of A group at 1 d and 7 d after operation(P<0.05),and the BUT value of B group was lower than that of A group and C group at 1 d,7 d and 30 d after operation(P<0.05);The FL value between A group and C group at 1 d,7 d,30 d and 90 d after treatment was not significant(P>0.05).The FL value of B group returned to the level before treatment at 30 d after operation,and the FL value of B group was higher than that of A group and C group at 1 d and 7 d after operation(P<0.05);There was little difference in the incidence of co

关 键 词：超声乳化白内障吸除术 糖尿病 2型 白内障 

分 类 号：R779.66[医药卫生—眼科] R587.2[医药卫生—临床医学]