双氯芬酸在合并虹膜剥脱综合征的白内障术中的应用研究

Application Study of Diclofenac Sodium in Incorporated Iris pigment exofoliation syndrome in Cataract Operation

目的:观察双氯芬酸滴眼液在合并剥脱综合征的白内障术中抑制瞳孔缩小及减轻术后炎症反应的作用。方法:选择剥脱综合征并白内障的55例作为研究对象,随机将患者分成试验组26例和对照组29例,对照组术前1小时使用复方托吡卡胺滴眼液散瞳,术后予复方妥布霉素滴眼液(妥布霉素和地塞米松合剂)点眼;试验组术前3天加用双氯芬酸滴眼液,术前1小时使用复方托吡卡胺滴眼液散瞳,术后予复方妥布霉素滴眼液、双氯芬酸钠滴眼液点眼。比较两组术前、术后瞳孔变化及术后炎症反应消退的时间。结果:试验组术前瞳孔直径为(6.69±0.40)mm,术后为(5.93±0.40)mm;对照组术前为(5.94±0.68)mm,术后为(4.41±0.29)mm,两组比较差异有统计学意义(P<0.01)。术后晶体核硬度Ⅱ度、Ⅲ度、Ⅳ度恢复时间试验组分别为(4.00±1.31)天、(4.50±1.17)天、(6.00±1.41)天,对照组分别为(5.40±1.14)天、(6.00±1.21)天、(7.25±1.04)天,两组比较差异有统计学意义(P<0.05)。术后试验组不同年龄段浮游物消退时间与对照组比较差异有统计学意义(P<0.01)。结论:合并剥脱综合征的白内障患者实施手术时,术前、术后使用双氯芬酸滴眼液,术中可充分维持瞳孔,术后可减轻前房炎症反应,效果显著。

Objective ：To investigate the function of diclofenac sodium eye drops in restraining constriction of pupil inoperative and lessening inflammatory postoperative reaction in the cataract operation, which incorporated exofoliation syndrome. Methods： 55 pa- tients were divided into two groups;control group（ n = 29） and test group（ n = 26） randomly;using complex tropicamide eye drops in both two groups one hour before the operation, using the complex tenebrimycin eye drops after the operation, at the same time in test group,using diclofenac sodium eye drops 3 days before the operation,and using diclofenac sodium eye drops after the opteration. Changes of constriction of pupil and inflammatory reaction were observed. Results ： Pupillary diameter was larger in test group （6.69 ± 0.40）mm before the operation and （5.93 ± 0.40）mm after operation and（5.94 ± 0.68）mm in control group preoperation and （4.41 ± 0.29）mm after operation with significant difference （p 〈 0.01 ）. Postoperative recovery time of Ⅱ,Ⅲ and Ⅳ crystal nucleusi in test group were （4.00 ± 1.31 ） days, （4.50 ± 1.17 ） days and （6.00 ± 1.41 ） days and （5.40 ± 1.14 ） days, （ 6. 00 ± 1.21 ）days, （7.25 ± 1.04 ）days respectively with significant difference（ P 〈 0. 05 ） . The time of inflammatory reaction subsi- ded completely was shorter in test group （ P 〈 0. 05 ）. Conclusion ： Diclofenac sodium eye drops preoperation and postoperation in the cataract operation which incorporated exofoliation syndrome can sustain pupillary diameter during operation and relieve postoperative inflammatory reaction.