摘要
目的观察术前预防性使用玻璃酸钠滴眼液对合并糖尿病的白内障患者术后干眼的疗效。方法选择56例(56眼)合并糖尿病的白内障患者,随机将患者分成试验组(28例,28眼)和对照组(28例,28眼)。试验组术前1周开始使用0.1%玻璃酸钠滴眼液,术前3 d联合使用0.5%左氧氟沙星滴眼液;对照组术前3 d使用0.5%左氧氟沙星滴眼液。比较两组患者术后1、7、28 d的眼表疾病指数量表(OSDI)评分、泪液分泌试验、荧光素钠染色泪膜破裂时间(FBUT)、角膜荧光素钠染色(FL)评分。结果术后1、7、28 d,试验组OSDI评分分别为(38.04±7.82)、(14.51±6.77)、(9.00±5.98)分,FBUT分别为(3.93±1.02)、(7.21±1.55)、(10.12±2.73)s,FL评分分别为(6.93±1.39)、(4.61±0.92)、(1.85±1.29)分,泪液分泌试验滤纸条浸湿长度分别为(2.55±0.72)、(5.45±0.90)、(10.50±1.62)mm/5 min,对照组OSDI评分分别为(46.91±8.76)、(32.71±8.04)、(17.86±5.89)分,FBUT分别为(2.57±1.17)、(4.07±0.94)、(7.64±1.62)s,FL评分分别为(10.39±1.23)、(8.89±0.78)、(6.00±0.86)分,泪液分泌试验滤纸条浸湿长度分别为(1.22±0.79)、(4.53±1.03)、(7.31±1.06)mm/5 min。组内比较:两组患者术后28 d的OSDI评分、FL评分比术后1、7 d低,术后7 d比术后1 d低;术后28 d的FBUT、泪液分泌试验滤纸条浸湿长度比术后1、7 d长,术后7 d比术后1 d长;且组内不同时间点比较差异有统计学意义(P<0.05)。组间比较:试验组OSDI评分、FL评分在术后1、7、28 d均低于对照组,FBUT、泪液分泌试验滤纸条浸湿长度均长于对照组,差异均有统计学意义(P<0.05)。结论术前预防性使用0.1%玻璃酸钠滴眼液,能够有效改善合并糖尿病的白内障患者术后干眼症状,恢复泪膜稳定性,促进泪液分泌以及眼表上皮愈合。
Objective To observe the efficacy of preoperative use of sodium hyaluronate eye drops on postoperative dry eye in cataract patients with diabetes mellitus.Methods 56 cataract patients(56 eyes)with diabetes mellitus were selected.The patients were randomly divided into an experimental group(28 patients,28 eyes)and a control group(28 patients,28 eyes).The experimental group started using 0.1%sodium hyaluronate eye drops 1 week before surgery,and combined with 0.5%levofloxacin eye drops 3 d before surgery;the control group used 0.5%levofloxacin eye drops 3 d before surgery.Patients in both groups were compared in terms of Ocular Surface Disease Index(OSDI)score,SchirmerⅠtest,tear breakup time(TBUT),and fluorescein sodium staining(FL)score 1,7,and 28 d after surgery.Results 1,7,and 28 d after surgery,the OSDI scores of the experimental group were(38.04±7.82),(14.51±6.77),and(9.00±5.98)points,the FBUT were(3.93±1.02),(7.21±1.55),and(10.12±2.73)s,the FL scores were(6.93±1.39),(4.61±0.92),and(1.85±1.29)points,and the wet lengths of the filter paper strips in SchirmerⅠtest were(2.55±0.72),(5.45±0.90),and(10.50±1.62)mm/5 min;the OSDI scores of the control group were(46.91±8.76),(32.71±8.04),and(17.86±5.89)points,the FBUT were(2.57±1.17),(4.07±0.94),and(7.64±1.62)s,the FL scores were(10.39±1.23),(8.89±0.78),and(6.00±0.86)points,and the wet lengths of the filter paper strips in SchirmerⅠtest were(1.22±0.79),(4.53±1.03),and(7.31±1.06)mm/5 min.Intra-group comparison:The OSDI score and FL score of the two groups of patients 28 d after surgery were lower than those 1 and 7 d after surgery,and the scores 7 d after surgery were lower than those 1 d after surgery;the FBUT and wet lengths of the filter paper strips in SchirmerⅠtest 28 d after surgery were longer than those 1 and 7 d after surgery,and the length 7 d after surgery was longer than that 1 d after surgery;moreover,there were statistically significant differences at different time points within the groups(P<0.05).Inter-group comparison:The OSDI score and FL score of the experimental group were lower than those of the control group 1,7,and 28 d after surgery;the FBUT and wet lengths of the filter paper strips in SchirmerⅠtest were longer than those of the control group;the differences were statistically significant(P<0.05).Conclusion Prophylactic use of 0.1%sodium hyaluronate eye drops before surgery can effectively improve dry eye symptoms in patients with cataract patient with diabetes mellitus,restore tear film stability,promote tear secretion and ocular surface epithelial healing.
作者
王哲
齐佳
谢洁
柳杨
李林
袁洋行
李仁芳
WANG Zhe;QI Jia;XIE Jie(Heyuan People's Hospital,Heyuan 517000,China)
出处
《中国实用医药》
2025年第20期29-33,共5页
China Practical Medicine
基金
北京医学奖励基金会项目(项目编号:YXJL-2023-0227-0100)。
关键词
玻璃酸钠滴眼液
术前
干眼
糖尿病
白内障
Sodium hyaluronate eye drops
Preoperative
Dry eye
Diabetes mellitus
Cataract
