角巩膜缘切口白内障超声乳化术治疗合并2型糖尿病的白内障患者的临床研究  

The effect of phacoemulsification through corneoscleral incision on 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12期1828-1831,1837,共5页Journal of Chinese Physician

基　　金：河北省卫生和计划生育委员会科研基金(20180206)。

摘　　要：目的探讨角巩膜缘切口白内障超声乳化术治疗合并2型糖尿病的白内障患者的效果。方法前瞻性选取河北医科大学第一医院2018年1月至2019年6月期间收治的合并2型糖尿病的白内障患者,均拟行白内障超声乳化术治疗。采用随机数字表法分为3组,其中角巩膜缘切口40例(68眼)为A组,上方透明角膜切口40例(66眼)为B组,颞侧透明角膜切口40例(70眼)为C组。比较3组患者术后1、7、30、90 d干眼症状量表评分、角膜荧光素染色(FLS)评分、泪膜破裂时间(BUT)、基础泪液分泌试验(SIt);比较3组患者术前、术后7 d房水白介素-6(IL-6)、白介素-8(IL-8)水平。结果⑴3组患者术后7 d房水IL-6、IL-8水平较术前明显降低,其中A组降低更明显(P<0.05),而B、C组房水IL-6、IL-8水平比较差异无统计学意义(P>0.05);⑵B组术后1、7 d干眼症状量表评分均明显高于A组(P<0.05);C组术后1、7、30 d干眼症状量表评分均明显高于A、B组(P<0.05);A、B组术后30 d干眼症状量表评分降至术前水平(P>0.05),C组术后90 d干眼症状评分降至术前水平(P>0.05);⑶A、C组术后1、7、30 d BUT明显高于B组(P<0.05),SIt水平明显低于B组(P<0.05);A组术后1、7 d SIt明显低于C组(P<0.05);A、C组术后1、7 d FLS评分明显低于B组(P<0.05)。结论角巩膜缘切口对行白内障超声乳化术治疗的合并2型糖尿病的白内障患者的泪膜稳定性、眼表功能影响较小,值得临床推荐。Objective To explore the effect of phacoemulsification through corneoscleral incision on cataract patients with type 2 diabetes mellitus.Methods A prospective case-control study was conducted to collect cataract patients with type 2 diabetes who were admitted to the First Hospital of Hebei Medical University from January 2018 to June 2019.All patients were treated with phacoemulsification.They were randomly divided into three groups:40 cases(68 eyes)of corneoscleral incision,40 cases(66 eyes)of upper transparent corneal incision and 40 cases(70 eyes)of temporal transparent corneal incision.The dry eye symptom scale score,corneal fluorescein staining(FL)score,tear rupture time(BUT)and Schirmer I test(SIt)were compared in three groups;The levels of interleukin-6(IL-6)and interleukin-8(IL-8)in aqueous humor were compared among the three groups before and 7 days after operation.Results⑴The levels of IL-6 and IL-8 in aqueous humor of the three groups were significantly lower than those before operation,especially in group A(P<0.05),but there was no significant difference in the levels of IL-6 and IL-8 in aqueous humor of group B and C(P>0.05);⑵The scores of dry eye symptoms in group B were significantly higher than those in group A at 1 and 7 days after operation(P<0.05);The scores of dry eye symptoms in group C were significantly higher than those in group A and B at 1,7 and 30 days after operation(P<0.05);The dry eye symptom score in group A and B decreased to the preoperative level 30 days after operation(P>0.05),and that in group C decreased to the preoperative level 90 days after operation(P>0.05);⑶The postoperative 1,7 and 30 d BUT in group A and C were significantly higher than those in group B(P<0.05),and the level of SIt was significantly lower than that in group B(P<0.05);At 1 and 7 days after operation,SIt in group A was significantly lower than that in group C(P<0.05);the FLS score in group A and C was significantly lower than that in group B at 1 and 7 days after operation(P<0.05).Conclusions The in

关 键 词：超声乳化白内障吸除术 巩膜缘切口 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]