糖尿病患者白内障术前双氯芬酸钠滴眼的意义

The effect of the use of Diclofenac sodium eye drops before cataract surgery of diabetic patients

目的观察糖尿病患者白内障术前应用双氯芬酸钠滴眼液缩短散瞳时间，减少术中瞳孔回缩及减轻术中疼痛的作用。方法糖尿病并发双眼白内障36例，随机确定患者一眼为观察组，另一眼为对照组。观察组术前3d采用常规抗生素滴眼联合双氯芬酸钠滴眼液滴眼，术前1h复方托吡卡胺滴眼液以及双氯芬酸钠滴眼液交替滴眼；对照组术前3d采用常规抗生素滴眼液，术前1h单用复方托吡卡胺滴眼液散瞳。对两组进行观察比较。结果观察组术前散瞳至7mm的时间为（40．97±7．71）min，短于对照组的（56．50±10．22）min，差异有统计学意义（t=7．280，P=0．000）；观察组术中瞳孔回缩者占47．2％，低于对照组的97．2％，差异有统计学意义（χ2=22．430，P=0．000）；观察组术中无明显疼痛感者占52．8％，高于对照组的2．8％，差异有统计学意义（χ2=25．030，P=0．000）。结论糖尿病患者白内障术前应用双氯芬酸钠滴眼液能够较快散瞳，术中能较好地维持瞳孔散大状态并减轻疼痛。

Objective To observe the effect of use of Diclofenac sodium eye drops before cataract surgery of diabetic patients, about shortening the time of the pupil dilation, reducing of the intraoperative pupil retraction and mitigating intraoperative pain. Methods A total of 36 patients with diabetes and bilateral cataract were collected. One eye of each patient were randomly selected as observation group and the other eye as control group. The observation group received application of Diclofenac sodium eye drops on the basis of routine antibiotic eyes drops at 3 days before operation. One hour before surgery they took turns using Compound tropicamide eye drops and Diclofenac sodium eye drops. The control group were given routine antibiotic eye drops only 3 days before operation. Compound tropicamide eye drops was applied 1 hour before surgery. Results The time before pupil dilation reached 7 mm in observation group was （40.97 ±7.71 ） min, which was shorter than that in control group （56.50 ± 10.22 ） min. The difference was statistically significant between the two groups （ t = 7. 280, P = 0. 000）. The intraoperative pupil retraction in observation group accounted for 47. 2%, which was lower than that in control group of 97. 2%, the difference was statistically significant （χ2 = 22. 430, P = 0. 000）. Patients without intraoperative pain in observation group accounted for 52.8%, which was higher than that in control group of 2.8%, the difference was statistically significant （χ2 = 25. 030, P = 0. 000）. Conclusion The application of Diclofenac sodium eye drops for cataract surgery of diabetic patients can achieve faster pupil dilation effect of mydriasis, better maintains the pupil mydriasis and relieve the pain during the surgery.