不同眼部保护方式预防心脏外科手术中暴露性角膜炎的效果

Effect of different eye protection methods in exposure keratitis prevention in cardiac surgeries

目的探讨不同眼部保护方式预防心脏外科手术中暴露性角膜炎的临床效果。方法2015年1-12月将210例心脏手术患者应用随机数字表分为医用防过敏3M胶布组、医用普通贴膜组、医用几丁糖眼膜组，每组各70例。比较三组患者术后48h内是否出现眼干、畏光、流泪、异物感和局限性疼痛等不适主诉，是否出现结膜充血、水肿、角膜干燥等临床体征。结果医用防过敏3M胶布组发生暴露性眼角膜炎17例、医用普通贴膜组发生6例、医用几丁糖眼膜组发生3例，三组比较差异有统计学意义（χ2=14．310，P〈0．05）。结论采取医用普通贴膜组能有效预防全麻术后暴露性角膜炎的发生，且价格便宜，医用几丁糖眼膜临床使用更安全，但价格相对昂贵，两者均具有较好的临床应用价值。

Objective To explore the effect of different eye protection methods in exposure keratitis prevention in cardiac surgeries. Methods From January to December 2015, 210 patients having undergone cardiac surgeries were divided by random number table into medical hypoallergenie 3M adhesive plaster group, general medical pad pasting group and medical chitosan mask group, each with 70 cases. Within 48h after the surgery, patients in the three groups were compared about whether they had uncomfortable complaint like eye dryness, photophobia, lacrimation, foreign body sensation, localized pain, etc. or clinical symptoms like conjunctival injection, edema, cornea dryness, etc. Results 17 patients got exposure keratitis in the medical hypoallergenie 3M adhesive plaster group, while 6 in the general medical pad pasting group and 3 in the medical chitosan mask group （χ2 = 14.310, P〈0.05） .Conclusions General medical pad pasting can effectively prevent exposure keratitis after surgery with general anesthesia. The effectiveness and its reasonable price make it worth applying in clinic.