【摘要】： 目的 初步探討玻璃切除手術對于糖尿病視網(wǎng)膜病變患者眼表及淚膜功能的影響,以及術后淚膜功能的恢復情況。 方法 按照本研究的納入和排除標準,觀察了35例(42眼)行玻璃體切除手術的患者,玻璃體切除手術后應用妥布霉素地塞米松眼液、眼膏,必要時聯(lián)合應用散瞳眼液和降眼壓眼液。分別于術前3d,術后7d、14d及30d詳細詢問患者是否存在不適癥狀(干澀感、異物感、燒灼感)并評分,并行淚膜破裂時間(Break-Up Time,BUT)、角膜熒光素染色(Cornea Fluorescein Staining, CFS)檢查及評分、淚液分泌試驗(Schirmer test, ST).對檢查結果進行統(tǒng)計學分析。 結果 與手術前相比,術后第7d患者的不適癥狀評分和CFS評分較術前顯著增加(P0.05),無法形成穩(wěn)定的淚膜,ST顯著增加。術后第7d、14d的不適癥狀評分較術前增加且差異性顯著(P0.05),至術后30d恢復至術前水平(P0.05)。術后第7d、14d,BUT較術前減少且差異性顯著(P0.05),ST和CFS較術前增加且差異性顯著(P0.05)。至術后30d,BUT和CFS較術前仍減少且差異性顯著(P0.05),ST與術前相比未見顯著性差異(P0.05),恢復至術前水平。 結論 玻璃體切除手術顯著影響淚膜的穩(wěn)定性。至術后30d,只有淚膜的部分功能指標恢復至術前水平。
[Abstract]:Objective to investigate the effect of vitrectomy on the function of ocular surface and tear film in patients with diabetic retinopathy and the recovery of lacrimal film function after vitrectomy. Methods according to the criteria of inclusion and exclusion, 35 cases (42 eyes) of vitrectomy were treated with tobramycin dexamethasone eye fluid and ointment after vitrectomy. Use mydriatic and hypotensive eye drops when necessary. At 3 days before operation, 14 days after operation and 30 days after operation, the patients were asked whether there were any symptoms (dry, foreign body sensation, burning sensation) and score, lacrimal film rupture time (Break-Up Time,BUT), corneal fluorescein staining (Cornea Fluorescein Staining, CFS) examination and score, tear secretion test (Schirmer test, ST). The results were analyzed statistically. Results compared with those before operation, the scores of discomfort symptom and CFS were significantly increased on the 7th day after operation (P0.05), but there was no stable tear film, and ST was significantly increased. The scores of discomfort symptoms increased significantly on the 7th day after operation (P0.05), and recovered to the preoperative level 30 days after operation (P0.05). On the 7th day after operation, but decreased and the difference was significant (P0.05), ST and CFS were significantly higher than those before operation (P0.05). At 30 days after operation, but and CFS still decreased and the difference was significant (P0.05), ST compared with pre-operation no significant difference (P0.05), recovered to the preoperative level. Conclusion vitrectomy has a significant effect on the stability of tear film. At 30 days after operation, only some of the functional indexes of tear film recovered to the preoperative level.
【學位授予單位】：中國醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R779.6

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