摘要
目的比较白内障术前给予非甾体类口服药或非甾体类滴眼液对术后黄斑水肿的作用。方法将拟行白内障超声乳化吸除术的老年性白内障患者115例(135眼)随机分为A组(31例,31眼)、B组(26例,32眼)、C组(30例,42眼)、D组(28例,30眼)。A组术前3 d开始口服布洛芬缓释胶囊,B组术前3 d开始滴用普拉洛芬眼水,C组术后开始滴用普拉洛芬眼水,D组术前术后不使用任何非甾体抗炎药(NSAIDs)。术后除D组外其他各组患者均给予典必殊眼水、普拉洛芬眼水滴眼,D组仅使用典必殊眼水。分别于术后1 d,1、2、4、6、12周随访,行光学相干断层扫描(OCT),主要比较各组间黄斑水肿的发生情况。结果术后1 d,1、2、4周,各组间黄斑水肿发生率差异无统计学意义,术后6周,各组间黄斑水肿发生率差异有统计学意义(P<0.05),其中D组黄斑水肿发生率明显高于其他3组(P<0.05),A、B、C 3组间黄斑水肿发生率差异无统计学意义。术后12周,各组间黄斑水肿发生率差异有统计学意义(P<0.05),其中C组、D组黄斑水肿发生率明显高于A组、B组(P<0.05),A组与B组、C组与D组黄斑水肿发生率差异无统计学意义。结论术前开始应用NSAIDs比术后开始应用可显著降低术后黄斑水肿发生率;术前口服NSAIDs与局部用非甾体类滴眼液相比未表现出明显优势。
Objective To compare the preventive effectiveness of oral non-steroidal anti-inflammatory drugs and non-steroidal anti-inflammatory eye drops on macular edema when used before uneventful phacoemulsification surgery.Methods 115 patients（135 eyes）who were going to undergo phacoemulsification were randomly divided into four groups,which are group A（31 cases,31 eyes）,group B（26 cases,32 eyes）,group C（30 cases and 42eyes） and group D（28 cases,30 eyes）.Group A was given ibuprofen sustained-release capsules 3 days before surgery;group B was given Pula ibuprofen eye drops 3 days before surgery;group C was given Pula ibuprofen eye drops after surgery and group D was not given any non-steroidal anti-inflammatory drugs.All groups except D were given Tobradex and Pula ketoprofen eye drops and group D was only given Tobradex eye drops postoperatively.The patients were fellowed up to be examined by optical coherence tomography before operation and in the first day,the first week,the second week,the fourth week,the sixth week,the twelfth week after operation.The incidence of macular edema would be recorded.Results The differences of the incidence of macular edama between groups were not statistically significant in the first day,the first week,the second week and the fourth week,and was statistically significant in the sixth week and the twelfth week（P0.05）.In the sixth week,the incidence of macular edema in group D was significantly higher than the other three groups（P0.05）.There were no significant statistic differences in the incidence of macular edama in the A,B,C groups.In the twelfth week,the incidence of macular edema in group C and group D was significantly higher than the other two groups（P0.05）.There were no significant statistic differences in the incidence of macular edama between groups A and B,as well as groups C and D.Conclusion The application of non-steroidal anti-inflammatory drugs before surgery would more significantly reduce the incidence of macular edema than postoperative application;oral non-steroidal anti-inflammatory drugs would not be better than non-steroidal anti-inflarmnatory eye drops on the prevention of macular edema when used before uneventful phacoemulsification surgery.
出处
《安徽医科大学学报》
CAS
北大核心
2013年第1期38-42,共5页
Acta Universitatis Medicinalis Anhui
