术中应用无防腐剂的1%利多卡因抑制后发性白内障的临床研究
发布时间：2019-06-06 03:45
【摘要】： 目的 后发性白内障(after cataract, AC),又称为后囊膜混浊(posterior capsule opacification, PCO),是白内障囊外摘除术伴或不伴人工晶体植入术后常见的也是当今世界范围内热点研究的并发症,术后残留的晶状体上皮细胞(lens epithelialcells,LECs)的移行和增殖是其发生的中心环节和细胞学基础。长期以来,眼科工作者一直在寻求能应用于眼内的清除或抑制晶状体上皮细胞的药物来预防白内障术后囊膜混浊这一常见并发症。本研究探讨白内障超声乳化术中水分离时应用无防腐剂的1%利多卡因对后发性白内障形成的影响,为寻求白内障术中清除晶状体上皮细胞,预防囊膜混浊提供有效药物的实验依据。 方法 收集2009年3月至2009年10月期间于郑州大学第二附属医院眼科治疗的年龄相关性白内障患者65例72只眼,随机分为对照组即A组,水分离时使用平衡盐溶液(balanced salt solution, BSS)和用药组即B组,水分离时使用无防腐剂的1%利多卡因,其年龄分布42～85岁,平均68.58±13.32岁。在白内障超声乳化术中,使用无防腐剂的1%利多卡因在晶状体囊袋内进行水分离,使其直接快速作用于晶状体上皮细胞。于白内障超声乳化吸出术联合人工晶体植入手术术前1天、术后第1天、术后第3天测量术眼眼压情况,术前1天、术后3天检测术眼角膜内皮情况,术后第1天、第3天、第7天、第14天和术后第1月、第3月、第6月在裂隙灯显微镜下检查手术眼的切口愈合程度、角膜恢复情况以及前房是否有炎症反应等,术后第1月、术后第6月检查其最佳矫正远视力,并且于术后第1月、第3月、第6月在裂隙灯显微镜下观察后囊膜混浊情况,通过比对后囊膜混浊的标准,进行对后囊膜混浊程度的评分,比较各组晶状体后囊混浊情况。采用SPSS13.0统计软件进行统计处理。 结果 1.术后角膜情况 术后3天几乎所有术眼切口周围角膜均有水肿,多为轻度水肿,但均在1周内消失,从发生角膜水肿眼数的情况比较,两组间差异无统计学意义(χ2=0.215,P0.05)。从角膜水肿程度来看,术后第7天,两组间差异无统计学意义(Z=-0.486,P0.05)。 2.术后前房情况 术后第1天和第3天两组部分术眼出现前房反应,从发生前房反应眼数的情况比较,两组间差异无统计学意义(χ2=0.400,P0.05)。术后第7天观察两组前房反应情况,A组只有1例出现前房反应。从房水混浊程度对情况进行比较,术后第7天,两组间差异无统计学意义(Z=-1.000,P0.05)。 3.术眼眼压情况 术前1天,A、B两组间眼压比较结果,差异无统计学意义(t=0.120,P0.05),术后第1天,A、B两组间眼压比较结果,差异无统计学意义(t=0.812,P0.05),术后第3天,A、B两组间眼压比较结果,差异无统计学意义(t=-0.981,P0.05)。 A组术前1天和术后第1天相比较,差异有统计学意义(t=-20.018,P0.05),术前第1天和术后第3天相比较,差异无统计学意义(t=0.117,P0.05),术后第1天和术后第3天相比较,差异有统计学意义(t=20.273,P0.05)。B组术前第1天和术后第1天相比较,差异有统计学意义(t=-20.673,P0.05),术前第1天和术后第3天相比较,差异无统计学意义(t=0.887,P0.05),术后第1天和术后第3天相比较,差异有统计学(t=19.900,P0.05)。 4.术后最佳矫正远视力 术后第1个月,A组与B组的最佳矫正远视力比较,差异无统计学意义(t=-0.645,P0.05)。术后第6个月,A组与B组的最佳矫正远视力比较,差异有统计学意义(t=-2.763，P0.05)。 5.术眼角膜内皮情况 术前1天,A组与B组术眼角膜内皮密度比较,差异无统计学意义(t=-1.163,P0.05)。术后3天,A组与B组术眼角膜内皮密度比较,差异无统计学意义(t=1.326，，P0.05)。6.术后后囊混浊情况 术后1个月,A组有2只眼出现后囊膜混浊,B组有1只出现后囊膜混浊,两组比较,差异无统计学意义(χ2=0.348,P0.05)。术后3个月,A组有5只眼出现后囊膜混浊,B组有2只出现后囊膜混浊,两组比较,差异无统计学意义(χ2=1.424,P0.05)。术后6个月,A组有18只眼出现后囊膜混浊,B组有3只出现后囊膜混浊,两组比较,差异有统计学意义(χ2=15.126,P0.05)。 术后1个月,A组与B组的后囊膜混浊分值比较,差异无统计学意义(Z=-0.602,P0.05)。术后3个月,A组与B组的后囊膜混浊分值比较,差异无统计学意义(Z=-1.151,P0.05)。术后6个月,A组与B组的后囊膜混浊分值比较,差异有统计学意义(Z=-3.885,P0.05)。 结论 本研究表明,在白内障超声乳化术中水分离时,于晶状体囊袋内注射无防腐剂的1%利多卡因,能够在破坏晶状体上皮细胞的同时,不会损伤眼内其他组织,从而较安全有效的抑制后发性白内障的形成,并可能成为一种更快捷、方便、可靠的防治后发障的临床应用方案。
[Abstract]:Purpose Posterior capsular opacification (PCO), also known as posterior capsule opacification (PCO), is common to extracapsular cataract extraction with or without intraocular lens implantation. The migration and proliferation of the residual lens epithelial cells (LECs) after operation are the central link and the cell in which the complications occur. For a long time, ophthalmologists have long been looking for drugs that can be applied to the removal or suppression of lens epithelial cells in the eye, which is common in the prevention of capsular opacification after cataract surgery. The effect of 1% lidocaine without preservative on the formation of posterior cataract was discussed in this study. The effect of 1% lidocaine without preservative on the formation of posterior cataract was discussed, and the effective drug was provided for the prevention of lens epithelial cells and the prevention of capsular opacification. Yi Yi Methods From March 2009 to October 2009,65 cases of age-related cataract in the second affiliated hospital of Zhengzhou University were collected, and 65 cases were randomly divided into control group, group A, and balanced salt solution was used for water separation. BSS and group B,1% lidocaine without preservative was used at the time of water separation, and the age distribution was 42-85 years. 8.58 to 13.32 years of age. In phacoemulsification, a 1% lidocaine without a preservative was used to separate the water in the lens pocket, making it very fast Intraocular pressure was measured on the lens epithelial cells at a rate of 1 day before operation,1 day after operation,1 day after operation,1 day after operation,1 day after operation,3 days after operation, and 7 days after operation. On day 14 and in the first and third months of the operation, the degree of incision healing, the recovery of the cornea and the presence of an inflammatory reaction in the anterior chamber were examined under a slit-lamp microscope in the first month of the operation. and the posterior capsule opacification was observed under the slit lamp microscope in the first month, the third month and the sixth month after the operation, and the degree of the posterior capsule opacification was scored, compared, The posterior capsule of each group was turbid. SPSS13 was used. 0 series Statistical Office of the meter software Results 1. There were edema of the cornea in the surrounding cornea after operation for 3 days after the operation of the cornea, most of which were mild edema, but all disappeared within 1 week, and the difference between the two groups was compared with the case of the number of the corneal edema. There was no statistical significance (Sup2 = 0.215, P0.05). From the degree of corneal edema, the difference between the two groups was 7 days after operation. no statistical significance ( Z =-0.486, P <0.05).2. The anterior chamber response was observed in the first and third days after the operation of the anterior chamber. In comparison, there was no statistical difference between the two groups (Sup2 = 0.400, P0.001). 5) The anterior chamber response of the two groups was observed on the 7th day after the operation. On Day 7, the difference between the two groups There was no statistical significance (Z =-1.000, P0.05).3. The results of the intraocular pressure in the group A and B were not statistically significant (t = 0.120, P0.05). The results of the comparison of intraocular pressure showed no significant difference (t = 0.812, P0.05). The results showed no significant difference (t =-20.018, P0.05). The difference was not significant (t =-20.018, P0.05), and the difference was not significant (t = 0.117, P0. The difference was statistically significant (t =-20.73, P0.05), the difference was not significant (t =-20.673, P0.05), and the difference was not statistically significant (t = 0.887, P, P <0.05). 0.05), post-op day 1 Compared with the 3rd day after operation, the difference was statistically significant (t = 19.900, P0.05). In the first month of the operation, the best corrected distance between group A and group B was no significant difference (t =-0.645, P0. 05).6-month post-operation The difference between group A and group B was statistically significant (t =-2.763, P0.05). 5. There was no significant difference in the density of the corneal endothelium in group A and group B before operation (t =-). 1.163,P0 (.05). There was no significant difference between group A and group B (t = 1.326, P0.05).6. The posterior capsule opacification in group A and group B was not significant (t = 1.326, P0.05). One month after the operation, there were 2 eyes in group A and 2 eyes in group A, and 1 in group B was turbid. There was no statistical difference between the two groups (Sup2 = 0.348, P0.05). There were 2 cases of posterior capsule opacification in group A and 2 in group B after operation. There was no significant difference between the two groups (Sup2 = 1.424, P0.05). The posterior capsule opacification was found in 18 eyes in group A and the posterior capsule opacification in group B after 6 months, and there were 3 cases of posterior capsule opacification in group B. (2 = 15.126, P0.05). The posterior capsule opacification score of group A and group B was less than that of group B after operation for 1 month. The statistical significance (Z =-0.602, P0.05). The posterior capsule opacification score of group A and group B was less than that of group B after 3 months. Ji Xue Significance (Z =-1.151, P0.05). After 6 months of operation, the haze scores of the posterior capsule of group A and group B were statistically significant (Z =-3.885, P0.05). Conclusion This study shows that 1% lidocaine without preservative can be injected into the capsular bag when the water is separated in the phacoemulsification.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.66
本文编号：2494044
[Abstract]:Purpose Posterior capsular opacification (PCO), also known as posterior capsule opacification (PCO), is common to extracapsular cataract extraction with or without intraocular lens implantation. The migration and proliferation of the residual lens epithelial cells (LECs) after operation are the central link and the cell in which the complications occur. For a long time, ophthalmologists have long been looking for drugs that can be applied to the removal or suppression of lens epithelial cells in the eye, which is common in the prevention of capsular opacification after cataract surgery. The effect of 1% lidocaine without preservative on the formation of posterior cataract was discussed in this study. The effect of 1% lidocaine without preservative on the formation of posterior cataract was discussed, and the effective drug was provided for the prevention of lens epithelial cells and the prevention of capsular opacification. Yi Yi Methods From March 2009 to October 2009,65 cases of age-related cataract in the second affiliated hospital of Zhengzhou University were collected, and 65 cases were randomly divided into control group, group A, and balanced salt solution was used for water separation. BSS and group B,1% lidocaine without preservative was used at the time of water separation, and the age distribution was 42-85 years. 8.58 to 13.32 years of age. In phacoemulsification, a 1% lidocaine without a preservative was used to separate the water in the lens pocket, making it very fast Intraocular pressure was measured on the lens epithelial cells at a rate of 1 day before operation,1 day after operation,1 day after operation,1 day after operation,1 day after operation,3 days after operation, and 7 days after operation. On day 14 and in the first and third months of the operation, the degree of incision healing, the recovery of the cornea and the presence of an inflammatory reaction in the anterior chamber were examined under a slit-lamp microscope in the first month of the operation. and the posterior capsule opacification was observed under the slit lamp microscope in the first month, the third month and the sixth month after the operation, and the degree of the posterior capsule opacification was scored, compared, The posterior capsule of each group was turbid. SPSS13 was used. 0 series Statistical Office of the meter software Results 1. There were edema of the cornea in the surrounding cornea after operation for 3 days after the operation of the cornea, most of which were mild edema, but all disappeared within 1 week, and the difference between the two groups was compared with the case of the number of the corneal edema. There was no statistical significance (Sup2 = 0.215, P0.05). From the degree of corneal edema, the difference between the two groups was 7 days after operation. no statistical significance ( Z =-0.486, P <0.05).2. The anterior chamber response was observed in the first and third days after the operation of the anterior chamber. In comparison, there was no statistical difference between the two groups (Sup2 = 0.400, P0.001). 5) The anterior chamber response of the two groups was observed on the 7th day after the operation. On Day 7, the difference between the two groups There was no statistical significance (Z =-1.000, P0.05).3. The results of the intraocular pressure in the group A and B were not statistically significant (t = 0.120, P0.05). The results of the comparison of intraocular pressure showed no significant difference (t = 0.812, P0.05). The results showed no significant difference (t =-20.018, P0.05). The difference was not significant (t =-20.018, P0.05), and the difference was not significant (t = 0.117, P0. The difference was statistically significant (t =-20.73, P0.05), the difference was not significant (t =-20.673, P0.05), and the difference was not statistically significant (t = 0.887, P, P <0.05). 0.05), post-op day 1 Compared with the 3rd day after operation, the difference was statistically significant (t = 19.900, P0.05). In the first month of the operation, the best corrected distance between group A and group B was no significant difference (t =-0.645, P0. 05).6-month post-operation The difference between group A and group B was statistically significant (t =-2.763, P0.05). 5. There was no significant difference in the density of the corneal endothelium in group A and group B before operation (t =-). 1.163,P0 (.05). There was no significant difference between group A and group B (t = 1.326, P0.05).6. The posterior capsule opacification in group A and group B was not significant (t = 1.326, P0.05). One month after the operation, there were 2 eyes in group A and 2 eyes in group A, and 1 in group B was turbid. There was no statistical difference between the two groups (Sup2 = 0.348, P0.05). There were 2 cases of posterior capsule opacification in group A and 2 in group B after operation. There was no significant difference between the two groups (Sup2 = 1.424, P0.05). The posterior capsule opacification was found in 18 eyes in group A and the posterior capsule opacification in group B after 6 months, and there were 3 cases of posterior capsule opacification in group B. (2 = 15.126, P0.05). The posterior capsule opacification score of group A and group B was less than that of group B after operation for 1 month. The statistical significance (Z =-0.602, P0.05). The posterior capsule opacification score of group A and group B was less than that of group B after 3 months. Ji Xue Significance (Z =-1.151, P0.05). After 6 months of operation, the haze scores of the posterior capsule of group A and group B were statistically significant (Z =-3.885, P0.05). Conclusion This study shows that 1% lidocaine without preservative can be injected into the capsular bag when the water is separated in the phacoemulsification.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.66
【引证文献】
相关硕士学位论文 前1条
1 董伟华;两种不同类型人工晶状体植入术后前房深度和屈光度变化的临床研究[D];郑州大学;2013年
本文编号：2494044
本文链接：https://www.wllwen.com/yixuelunwen/yank/2494044.html
最近更新
教材专著
