乳酸林格氏液和平衡盐液对角膜内皮影响的临床观察

Effect of lactated Ringer's solution and balanced salt solution on the corneal endothelium

目的 探讨乳酸林格氏液和平衡盐液在小切口白内障摘除人工晶状体植入术中对角膜内皮的影响。方法 45例 (46只眼 )老年性白内障患者随机分为两组 ,分别以乳酸林格氏液 (2 3例 )和平衡盐液 (2 2例 )为灌注液。术式为非超声乳化小切口白内障摘除人工晶状体植入术。术前和术后 3个月行角膜内皮显微镜检查 ,观察角膜内皮细胞密度、平均内皮细胞面积、六边形细胞百分率和变异系数的改变。结果 41例患者 (91% )完成了术后随访。乳酸林格氏液组 (n =2 0 )角膜内皮细胞密度较术前减少 5 2 5± 192个 /m m2 ;平均盐液组 (n =2 1)减少 5 0 5±187个 /mm2 ,二者无显著性差异 (P >0 .0 5 )。乳酸林格氏液组平均内皮细胞面积较术前增加 (95 .1± 42 .6 ) μm2 ;平衡盐液组增加 (85 .9± 2 6 .4)μm2 ,二者无显著性差异 (P >0 .0 5 )。乳酸林格氏液组六边形细胞百分率较术前下降(11.1± 4.9) % ;平衡盐液组下降 (0 .9± 0 .2 ) % ,二者之间存在显著性差异 (P <0 .0 1)。乳酸林格氏液组变异系数较术前增加 (0 .12± 0 .0 3) ;平衡盐液组增加 (0 .0 5± 0 .0 4) ,二者之间存在显著性差异 (P <0 .0 5 )。结论 角膜内皮细胞形态学分析较细胞密度和平均面积的改变能更灵敏的反映角膜内皮的变化。平衡盐液对角膜内皮的?

Objective The aim of this clinical study is to compare the influence of corneal endothelium with Lactated Ringer's solution(LR) and Balanced Salt solution(BSS) during the small-incision extracapsular cataract extraction with intraocular lens implantation.Methods Forty-five patients(46 eyes)undergoing small-incision extracapsular cataract extraction with intraocular lens implantation were randomized between two irrigating solution groups, Lactated Ringer's solution (n=23)and balanced salt solution(n=22). Preoperative and postoperative endothelial specular photomicrographs were analyzed for cell density, cell size, hexagonality and coefficient of variation.Result Forty-one subjects(91%) completed the three-month study. Change in the percent hexagonality for the LR group(n=20) (Mean SD 11.1±4.9%) was significantly different from the BSS group(n=21) (0.9±0.2%) (P<0.01).Change in the coefficient of variation for the LR group (0.12±0.03) was also significantly different from the BSS group(0.05±0.04) (P<0.05).Groups did not differ significantly in endothelia cell density or in cell size(P>0.05).Conclusion BSS appears to be more effective in protecting endothelium than LR. It may be contribute to the presence of buffer system and Mg 2+ in BSS.