术前不同体位滴入散瞳药对老年性白内障患者散瞳效果的影响

Different postures may affect the effectiveness of preoperative mydriasis in senile patients with cataract

目的观察术前采取仰卧位、坐位滴入散瞳药对老年性白内障患者散瞳效果的影响。方法将需行术前散瞳的老年性白内障患者240例随机分为两组,观察组和对照组各120例。观察组术前滴入散瞳药时取仰卧位,对照组取坐位头向后仰位。测量、记录患者的基线瞳孔直径、首次滴眼散瞳后30min的瞳孔直径及晶体植入前的瞳孔直径,并计算散瞳前后瞳孔直径差值、术中瞳孔达标率,进行两组间的比较。结果最终完成本次研究的患者中,观察组102例,对照组116例。观察组首次滴入散瞳药后30min的瞳孔直径、晶体植入前的瞳孔直径及散瞳前后瞳孔直径差值均明显大于对照组(P<0.01)。观察组术中瞳孔理想达标率78.43%,基本达标率21.57%,未达标率0%;对照组术中瞳孔理想达标率56.90%,基本达标率40.52%,未达标率2.58%;两组比较,差异有统计学意义(P<0.01)。结论老年性白内障患者术前滴入散瞳药时取仰卧位的散瞳效果优于坐位。

Objective To evaluate the effectiveness of preoperative mydriasis at supine position and sitting position in patients with cataract. Methods Totally 240 senile cataract patients were randomly assigned to supine position and sitting posi tion during eyedropping. The pupil diameters before dilation（baseline） and at 30min after the first drop and before lens implanted were measured. The difference between pupil diameter before and after dilation and the compliance rate of operative pupil di- lation were compared between the two groups. Results The pupil diameter at 30min after the first drop,the pupil diameter before lens implanted and the difference between pupil diameter before and after dilation in the supine position group were significantly larger than those of the sitting position group（P〈0.01）. The compliance rate of operative pupil dilation in the supine position group was significantly higher than that of the sitting position group（P〈0.01）. Conclusion The effectiveness of pupil dilation at supine position is better than that of sitting position in senile patients with cataract.