阿托品防治青少年早发性近视的临床研究

发布时间：2018-04-18 10:57

  本文选题：阿托品 + 防治　； 参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]阿托品是目前控制青少年近视公认的比较有效的药物,但长期高频率点眼带来的副作用使得阿托品的临床使用受限,本研究旨在探讨间断使用1%阿托品眼用凝胶对青少年近视防治的有效性和安全性,以期能够探索最低使用频率控制近视进展的用药方法。[方法]收集2015年07月至2016年01月于昆明医科大学第四附属医院(云南省第二人民医院)儿童眼科门诊就诊的确诊为中低度近视、且符合纳入标准的患儿102例,分为A治疗组,平均年龄10.77±1.69岁,男13例,女17例,40眼(单眼或双眼近视度数为-0.50DS或-0.75DS,阿托品眼用凝胶用四周,即第一周点两次,第二周点一次,第三、四周停用);B治疗组平均年龄10.97±1.67岁,男16例,女14例,60眼(双眼近视,一月法,双眼交替使用,开始点右眼一次两周后点左眼一次,依次类推);C治疗组,平均年龄14.95±0.83岁,男11例,女9例,40眼(双眼近视,两月法,双眼交替使用,开始点右眼一次一月后点左眼一次,依次类推);对照D组,平均年龄10.64±1.73岁,男10例,女12例,44眼(双眼近视,常规验光戴镜);B、C、D组患者双眼近视度数≥-1.00DS,≤-6.00 D,散光≤-1.00 D。A组患儿一月后观察记录屈光度、眼轴、视力、眼压的变化。B、C组患儿根据视力和症状给予常规验光配镜观察,所有患者在受试前均接受全面的眼科检查作为基线标准,1年后观察各组屈光度、眼轴、视力、眼压的变化,比较相关数据进行统计分析。[结果]A组26例(86.67%)33眼完成了一月的观察治疗,一月后近视屈光度变化(0.16±0.27)D,眼轴增长为(0.002±0.26)mm;B、C、D 四组共 64 例(85.00%)完成了 1年的观察,其中B组26例52眼,C组16例32眼,D组22例44眼,经过一年左右观察,3组近视屈光度进展分别为(-0.39±0.28)D、(-0.47±0.17)D 和(-0.97±0.21)D;眼轴增长分别为(0.14±0.08)mm、(0.19±0.12)mm和(0.39±0.10)mm。B组和对照D组屈光度、眼轴长度变化有统计学意义(P0.05)。B组儿童点阿托品后单眼近视力达1.0平均需4.5天,畏光症状消失需4.4天。各组患儿眼压变化无统计学意义(P0.05),所有观察对象均未出现眼压显著升高。[结论]1.间断使用1%阿托品对控制中低度近视进展有效。2.1%阿托品间断交替点眼患儿无明显视近困难。3.1%阿托品间断使用对患儿眼压无明显影响。4.长期间断交替使用1%阿托品儿童耐受良好,医从性较高,是较适宜的给药方式。
[Abstract]:[objective] Atropine is an effective drug for the control of juvenile myopia, but the side effects of long-term high frequency point eye make the clinical use of atropine limited.The purpose of this study was to investigate the efficacy and safety of intermittent use of 1% atropine ophthalmic gel in the prevention and treatment of juvenile myopia, and to explore the method of using the lowest frequency to control the progression of myopia.[methods] from July 2015 to January 2016, 102 children who were diagnosed as moderate and low myopia at the fourth affiliated Hospital of Kunming Medical University (second people's Hospital of Yunnan Province) were divided into two groups.The mean age was 10.77 卤1.69 years old, male 13 cases, female 17 cases 40 eyes (monocular or binocular myopia degree -0.50 DS or -0.75 DS). Atropine ophthalmic gel was used for four weeks, that is, twice in the first week, once in the second week, and third, the average age in the treatment group was 10.97 卤1.67 years.There were 16 males and 60 females (binocular myopia, one-month method, alternate use of both eyes, starting point of right eye once a fortnight, point of left eye once, and so on). The average age of treatment group was 14.95 卤0.83 years old, male 11 cases, female 9 cases 40 eyes (binocular myopia, two-month method).The mean age of group D was 10.64 卤1.73 years old, male 10 cases and female 12 cases 44 eyes.The changes of diopter, axial vision, visual acuity and intraocular pressure were observed and recorded in group D with routine optometry wearing glasses 鈮，

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