Effect of local oxygen therapy on corneal edema after cataract surgery
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摘要:
目的 探讨局部氧疗治疗白内障术后角膜水肿的疗效。 方法 选取两个医院白内障手术术后角膜水肿患者66例,随机分成对照组和观察组,每组33例。对照组患者术后1 d开始予妥布霉素地塞米松滴眼液局部滴眼治疗,4次/d。观察组在对照组治疗基础上,术后1 d开始行局部氧疗,氧流量为5 L/min,1 h/次,2次/d。 结果 观察组患者术后第3、7、14和28天中央角膜厚度显著低于对照组患者(P<0.05),观察组患者术后第3、7、14和28角膜内皮细胞计数显著高于对照组患者(P<0.05)。观察组患者术后第3、7、14、28天内皮细胞面积显著高于对照组患者(P<0.05)。观察组患者术后第7、14和28天变异系数显著低于对照组患者(P<0.05)。观察组患者术后第14和28天六边形细胞百分率显著高于治疗前(P<0.05)。 结论 局部氧疗可有效减轻白内障术后角膜水肿,保留更多有功能的角膜内皮细胞,值得在临床上推广。 Abstract:Objective To explore the effect of local oxygen therapy on corneal edema after cataract surgery. Methods 66 corneal edema patients after cataract surgery were assigned to the control group and experimental group (n=33). Patients in the control group were treated with tobramycin and dexamethasone eye drops four times daily for 28 d postoperatively, and patients in the experimental group received local oxygen therapy at a flow rate of 5 L/min twice daily for 28 d besides the eye drops postoperatively. Results Central corneal thickness was significantly lower in the experimental group than that in the control group in 3, 7, 14 and 28 d postoperatively (P<0.05). Endothelial cell count was significantly higher in the experimental group than that in the control group in 3, 7, 14 and 28 d postoperatively (P<0.05). Endothelial cell size was significantly lower in the experimental group than that in the control group in 3, 7, 14 and 28 d postoperatively (P<0.05). Coefficient of variation was significantly lower in the experimental group than that in the control group in 7, 14 and 28 d postoperatively (P<0.05). Hexagonality was significantly higher in the experimental group than that in the control group in 14 and 28 d postoperatively (P<0.05). Conclusion Local oxygen therapy could effectively relive corneal edema after cataract surgery and save more functional corneal endothelial cell, which is worth popularizing clinically. -
Key words:
- local oxygen therapy /
- corneal edema /
- cataract surgery
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表 1 两组患者术前一般资料比较(n=33)
组别 女性(n) 男性(n) 年龄(岁) CCT(μm) ECC(个/mm2) ECS(μm2) CV(%) HG(%) 对照组 16 17 62.4±5.8 543.8±34.3 2588.2±321.8 385.2±43.1 33.6±4.1 57.4±6.4 观察组 17 16 61.8±6.1 546.1±33.2 2573.7±318.4 384.7±44.2 32.9±5.1 56.8±7.1 表 2 两组患者术后CCT比较(n=33, μm, Mean±SD)
组别 治疗前 术后3 d 术后7 d 术后14 d 术后28 d 对照组 632.5±38.5 616.7±33.4a 587.5±30.2a 574.6±25.8a 565.8±24.3a 观察组 628.1±36.7 599.3±31.5ab 570.4±31.3ab 560.8±23.7ab 551.7±22.5ab a与治疗前比较, P<0.05;b与对照组比较, P<0.05. 表 3 两组患者术后ECC比较(n=33, 个/mm2, Mean±SD)
组别 治疗前 术后3 d 术后7 d 术后14 d 术后28 d 对照组 2368.7±204.8 1935.3±193.2a 1843.4±190.4a 1711.7±183.2a 1625.5±172.8a 观察组 2335.1±214.4 2052.1±204.2ab 1975.2±188.5ab 1827.9±179.3ab 1774.4±185.9ab 与治疗前比较, aP<0.05; 与对照组比较,bP<0.05. 表 4 两组患者术后ECS比较(n=33, μm2, Mean±SD)
组别 治疗前 术后3 d 术后7 d 术后14 d 术后28 d 对照组 611.5±71.4 593.3±65.5 573.9±61.2a 564.1±57.7a 552.8±53.3a 观察组 618.3±73.7 561.1±61.6ab 541.7±58.7ab 530.2±51.5ab 513.5±50.7ab 与治疗前比较, aP<0.05; 与对照组比较,bP<0.05. 表 5 两组患者术后CV比较(n=33, %, Mean±SD)
组别 治疗前 术后3 d 术后7 d 术后14 d 术后28 d 对照组 44.1±5.3 42.8±4.8 42.4±4.7 39.8±4.6a 38.7±4.3a 观察组 44.7±5.5 41.3±4.7a 40.2±4.1ab 37.3±3.8ab 36.1±3.9ab 与治疗前比较, aP<0.05; 与对照组比较,bP<0.05. 表 6 两组患者术后HG比较(n=33, %, Mean±SD)
组别 术后1 d(治疗前) 术后3 d 术后7 d 术后14 d 术后28 d 对照组 46.7±5.5 43.1±4.6a 42.6±4.8a 40.8±4.6a 36.6±4.1a 观察组 47.1±5.8 45.7±5.3b 45.1±4.9b 43.3±5.3ab 40.9±4.4ab 与治疗前比较,aP<0.05; 与对照组比较,bP<0.05. -
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