摘要
目的观察白内障超声乳化手术灌注液中不同浓度肾上腺素的散瞳效果及对角膜内皮细胞的影响,探讨临床应用肾上腺素的合理浓度。方法选择单纯老年性白内障患者105例(120眼),随机分为A、B、C 3组,每组40眼,500 m L灌注液中分别加入0.1 m L、0.2 m L、0.5 m L 1‰肾上腺素注射液,均行白内障超声乳化吸除加折叠式人工晶状体植入手术,应用非接触型角膜内皮检测仪于术前及术后1周检测角膜内皮细胞密度、角膜内皮六角形细胞比例及角膜内皮细胞变异系数。结果 3组均能使术中瞳孔直径大于或等于手术开始时水平。术前3组角膜内皮细胞密度、角膜内皮六角形细胞比例、角膜内皮细胞变异系数差异无统计学意义(P>0.05)。术后1周,B组、C组角膜内皮细胞密度、角膜内皮六角形细胞比例低于术前(P<0.05),A组与术前差异无统计学意义(P>0.05),且3组间差异无统计学意义(P>0.05)。C组角膜内皮细胞变异系数高于术前(P<0.05),A组、B组角膜内皮细胞变异系数与术前差异无统计学意义(P>0.05),C组角膜内皮细胞变异系数高于A组(P<0.05)。结论由于肾上腺素的潜在毒性作用,白内障超声乳化手术中500 m L灌注液应加入0.1 m L 1‰肾上腺素维持术中扩瞳。
Objective To observe the effects of different concentrations of adrenalin in perfusion solution on mydriasis and the corneal endothelium in phacoemulsification cataract surgery and to discuss clinical rational concentration. Methods One hundred and five simple senile cataract patients（ 120eyes） were divided randomly into A,B and C groups（ each group with 40 patients）. 0. 1 m L,0. 2 m L and 0. 5 m L 1‰ adrenalin were added into 500 m L perfusion solution. Phacoemulsification and intraocular lens implantation were performed in all patients. Before surgery and 1 week after surgery,corneal endothelial density,the percentage of hexagonal cells and variable coefficient were detected by corneal endothelial cell instrument without touching. Results The pupil diameters in the 3 groups during operation were all greater than or equal to those of preoperation. The differences of the preoperative corneal endothelial cell density,the percentage of hexagonal and cells variable coefficient among the 3groups were not statistically significant（ P〈0. 05）. The postoperative cell density and the percentage of hexagonal cells were lower than those before operation. There was significant difference of group B and group C compared to that before operation respectively（ P〈0. 05） and the difference of group A was not statistically significant（ P〈0. 05）. There was no statistically significant difference among the three groups（ P〈0. 05）. The variable coefficient was higher than that before operation in group C（ P〈0. 05）. There was no statistically significant difference of variable coefficient in group A and group B compared to that before operation（ P〈0. 05）. The variable coefficient of group C was higher than that of group A（ P〈0. 05）. Conclusion The effective and the lowest adrenalin concentration（ 0. 1 m L 1‰ adrenalin in 500 m L perfusion solution） should be applied in phacoemulsification in consideration of the potential adrenalin toxicity.
出处
《河北医科大学学报》
CAS
2016年第7期802-805,共4页
Journal of Hebei Medical University
作者简介
赵娴（1978-），女，河北石家庄人，河北省石家庄市第一医院主治医师，医学硕士，从事眼科疾病诊治研究。
