改良护眼法对高原地区眼表感染的辅助治疗效果观察

Effect of improved eye shield method on adjuvant therapy for ocular surface infection at high altitude

目的探讨改良护眼法对高原地区眼表感染的辅助治疗的效果。方法于海拔4500 m高原地区选取200例急性眼表感染患者,随机分为常规组、改良组A、B、C、D,各40例,对常规组参照平原常规治疗方式进行;对4个改良组除常规治疗外,另给予以下处置:A组给予自制的医用敷料遮盖患眼;B组在A组基础上,加用生理盐水冲洗患眼眼睑+结膜囊;C、D组则将冲洗液分别换为硫酸庆大霉素注射液和氯霉素滴眼液。观察比较5组治疗后的效果,4个改良组治疗后细菌培养情况及3个给予冲洗处置组的不良反应发生情况。结果疗效比较,改良组C和D>改良组B>改良组A>常规组(P<0.05);改良组细菌培养阳性率A>B>C、D(P<0.05);治疗后改良组B未发现不良反应,D组有1例出现轻微的结膜刺激症状,而C组有10例出现不良反应,发生率远高于B、D两组(P<0.05)。结论以氯霉素滴眼液进行眼睑+结膜囊冲洗,配合无菌纱布覆盖患眼软保护,对野外高原地区眼表感染的治疗有着积极的效果,值得推广应用。

Objective To explore the effect of improved eye shield method on adjuvant therapy for ocular surface infection at high altitude, Methoda A total of 200 acute ocular surface infection patients at an altitude of 4500 m were selected and randomly divided into five groups （n=40）： the conventional group and groups A, B, C and D. The conventional group was treated with conventional therapy in plain regions, while the other four improved groups were treated with the following treatment in addition to conventional therapy： group A was treated with homemade medical dressings to the infected eyes; based on the treatment for group A, group B received saline flush of the infected eyelid ＋conjunctival sac; the flushing fluid for groups C and D was replaced with gentamycin sulfate injection and chloramphenicol eye drops respectively. The treatment effect in the five groups, the bacterial culture in the four improved groups and the adverse reactions in the three groups which received flushing treatment were compared. Resttlla Comparison of treatment effects： groups C and D 〉 group B 〉 group A 〉 conventional group （P 〈 0.05）; comparison of positive rates of bacteria culture in improved groups： group A 〉 group B 〉 groups C and D （P 〈 0.05）; improved group B had no adverse reaction, group D had one slight mucous irritation, and group C had 10 adverse reactions, the occurrence of which was much higher than that in group B and group D （P 〈 0.05）. Conclusion The treatment combining flushing of the infected eyelid ＋ conjunctival sac with chloramphenicol eye drops and soft protection of the infected eye with sterile gauze shows positive effect on treating ocular surface infection in high altitude field and is worth popularizing and applying.