摘要
目的:探讨糖尿病性白内障患者超声乳化吸除术后泪膜的改变及护理方法。方法:对38例(50眼)糖尿病性白内障患者行超声乳化白内障吸除及拆叠式后房型人工晶体植入术,观察分析术前及术后1、7、30、90 d患者的主观感觉、泪膜破裂时间(BUT)、基础泪液分泌试验(SIt)及干眼仪检查情况。结果:本组患者与术前相比,术后1、7、30 d术眼干燥、异物感、烧灼感加重,BUT缩短,干眼仪检查等级增高,差异均有统计学意义(P<0.05);而术后90 d接近术前水平,差异无统计学意义(P>0.05)。术后1 d泪液分泌量比术前增多,差异有统计学意义(P<0.05);而术后7、30、90 d接近术前水平,差异均无统计学意义(P>0.05)。结论:糖尿病性白内障患者超声乳化吸除术后早期泪膜可发生明显变化,表现为泪膜稳定性大幅度下降,泪液分泌量明显增加,同时泪膜脂质层形态也受到明显破坏,致部分患者术后出现干涩、异物感、烧灼感等干眼症状。术后要根据情况采取相应的护理措施,减轻患者泪膜的损伤和缓解眼部不适等干眼症状,提高其视觉质量。
Objective： To explore the tear film changes after phacoemulsification for patients with diabetic cataract and nursing methods.Methods： Phacoemulsification and implantation of posterior chamber intraocular lens were applied to 38 patients（50 eyes）,observing and analyzing patient s subjective feeling,tear film break-up time（BUT）,the results of Schirmer I test and dry eye test before operation and respectively on 1st,7th,30th and 90th day after operation.Results： Dry sensation in the operated eye on 1st, 7th and 30th day, foreign body sensation and burning sensation were worse, BUT shortened and dry eye test grade increased after operation, compared with those ones before operation and the differences were statistically significant （ P 〈0. 05 ） ; 90 days after operation , the ones mentioned above neared the preoperative levels （ P 〉 0. 05 ） ; the amount of tear was much more on 1 st day after operation than that before operation （ P 〈 0. 05 ） ; the amount of tear was close to the preoperative level on 7th , 30th and 90th day after operation （ P 〉0. 05 ）. Conclusion： The tear film changed obviously in the early stage after phacoemulsification, showing a significant decline in the tear film stability and increasing amount of tear, while the morphology of tear film lipid layer was apparently damaged. The foreign body sensation, burning flu - like dry eye occurred in some patients. According to these changes, correct nursing care can alleviate tear film damage and release patient＇s uncomfortable senses. Thereby the visual quality will be improved.
