不同方案治疗小切口白内障术后角膜2～3级水肿的效果观察

Effect observation of different therapeutic regimens on corneal edema in grade Ⅱ-Ⅲ after small-incision cataract surgery

目的探讨小切口白内障术后角膜2~3级水肿的临床治疗效果。方法选取2009年6月~2014年2月在本院进行白内障摘除术后角膜2~3级水肿的340例患者400眼,随机分为观察组和对照组,观察组采用10 ml 10%氯化钠溶液＋5 mg地塞米松（1 ml）＋维生素C 500 mg 1支,雾化喷眼,并用10%氯化钠溶液加入氯霉素滴眼液空瓶中滴眼（4次/d）＋妥布霉素地塞米松滴眼液滴眼（1滴/30 min）,每晚四环素可的松眼膏睡前涂眼。对照组予妥布霉素地塞米松滴眼液滴眼,1滴/30 min,每晚四环素可的松眼膏睡前涂眼。两组患者角膜水肿转为1级后出院门诊随诊观察。结果观察组2级角膜水肿患者术后第3天好转率明显高于对照组,差异有统计学意义（χ2=42.63,P=0.0000）,术后第7天治愈率明显高于对照组,差异有统计学意义（χ2=98.05,P=0.0000）;观察组3级角膜水肿患者术后第3天及术后第7天好转率明显高于对照组,差异有统计学意义（χ2=37.62、8.95,P=0.0000）。结论观察组采用的治疗小切口白内障术后角膜2~3级水肿的药物较为普通,临床治疗效果显著,治疗方案值得在白内障扶贫复明活动中推广。

Objective To explore the clinical therapeutic effect of corneal edema in grade Ⅱ-Ⅲ after small-incision cataract surgery. Methods 340 cases of patients（400 eyes） suffered from corneal edema in grade Ⅱ-Ⅲ after cataract surgery in our hospital from June 2009 to February 2014 were randomly divided into observation group and control group.In the observation group,10 ml 10% sodium chloride solution,5 mg dexamethasone（1 ml）,and 500 mg vitamin C were mixed for atomization sparging eyes.10% sodium chloride solution was put into empty bottle of chloramphenicol eye drops for eye drops four times per day.Tobramycin and dexamethasone eye drop was also used for eye drops every30 min per drip.Tetracycline cortisone eye ointment was painted for eyes before sleep every night.In the control group,only tobramycin and dexamethasone eye drop which was also used for eye drops（every 30 min per drip） and tetracycline cortisone eye ointment which was painted for eyes before sleep every night were selected.Patients in both groups were discharged from hospital and classified into outpatient follow-up observation when corneal edema turned into grade Ⅰ. Results Postoperative improvement rate in the third day in patients with corneal edema in grade Ⅱ in the observation group was higher than that in the control group,the difference was significant（χ2=42.63,P=0.0000）.The cure rate in the 7th day in patients with corneal edema in grade Ⅱ in the observation group was higher than that in the control group,the difference was significant（χ2=98.05,P=0.0000）.Postoperative improvement rate in the 3rdand 7thday in patients with corneal edema in grade Ⅲ in the observation group was higher than that in the control group,the difference was significant（χ2=37.62,8.95,P =0.0000）. Conclusion The drugs used for corneal edema in grade Ⅱ-Ⅲ after small-incision cataract surgery are very common and their therapeutic effects are very obvious.The therapeutic regimen in the observation group is worthy of expansion in the activity of cataract supporting the poor and regaining the sight.