中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2011年
11期
989-994
,共6页
王晓明%马鲁新%王利华%Eye Center
王曉明%馬魯新%王利華%Eye Center
왕효명%마로신%왕리화%Eye Center
远视%丙氧卡因%环喷托酯%阿托品%儿童%屈光,眼
遠視%丙氧卡因%環噴託酯%阿託品%兒童%屈光,眼
원시%병양잡인%배분탁지%아탁품%인동%굴광,안
Hyperopia%Propoxycaine%Cyclopentolate%Atropine%Children%Refraction
目的 探讨远视儿童应用1％环喷托酯滴眼液以及联合应用表面麻醉药丙美卡因滴眼液的远视屈光度的峰值时间,并比较应用1％环喷托酯与1％阿托品睫状肌麻痹验光的屈光度值的差异.方法 采用简单随机化分组方法将71例(141只眼)远视儿童[年龄(7.9±2.1)岁]分为A组(Pro +Cyc组)和B组(NS+ Cyc组).两组均于1％环喷托酯首次滴眼后30、40、50、60、70 min进行电脑验光和瞳孔直径测量,1周后给予1％阿托品凝胶点眼,连用3d后重复上述测量,分别为A'组及B'组.在对各组数据进行正态性检验及方差齐性分析后,应用重复测量数据的方差分析分别对A组、B组各时间点的电脑验光屈光度值及瞳孔直径进行比较；应用配对t检验分别对A组、B组各时间点电脑验光屈光度数与A'组、B'组电脑验光屈光度数进行比较；应用两组独立样本的t检验对A组屈光度数的峰值与A'组屈光度数的差值和B组屈光度数的峰值与B'组屈光度数的差值进行比较.结果 A组和B组屈光度数的峰值分别出现在1％环喷托酯首次滴眼后50和60 min.A组与A'组屈光度数峰值分别为(+4.44±2.34)和(+4.86±2.29)D,两者比较差异有统计学意义(t=11.16,P＜0.01)；B组与B '组屈光度数峰值分别为(+4.50±2.19)和(+5.04±2.10)D,两者比较差异有统计学意义(t =11.44,P＜0.01).A组屈光度数峰值与A'组屈光度数间的差异小于B组屈光度数峰值与B '组屈光度数间的差异(t= -1.99,P=0.048).A组和B组瞳孔直径的峰值分别出现在1％环喷托酯首次滴眼后50和60 min,均与其屈光度的峰值时间一致.结论 在我国3～ 14岁远视儿童中,单独应用1％环喷托酯滴眼3次,在首次滴眼后50至70 min验光可测得其最大的屈光度数；1％环喷托酯联合应用表面麻醉剂丙美卡因可使其峰值时间提前约10 min,并可增强1％环喷托酯的睫状肌麻痹作用.单独应用1％环喷托酯或丙美卡因与1％环喷托酯联合应用,均不能完全代替1％阿托品的睫状肌麻痹作用.
目的 探討遠視兒童應用1％環噴託酯滴眼液以及聯閤應用錶麵痳醉藥丙美卡因滴眼液的遠視屈光度的峰值時間,併比較應用1％環噴託酯與1％阿託品睫狀肌痳痺驗光的屈光度值的差異.方法 採用簡單隨機化分組方法將71例(141隻眼)遠視兒童[年齡(7.9±2.1)歲]分為A組(Pro +Cyc組)和B組(NS+ Cyc組).兩組均于1％環噴託酯首次滴眼後30、40、50、60、70 min進行電腦驗光和瞳孔直徑測量,1週後給予1％阿託品凝膠點眼,連用3d後重複上述測量,分彆為A'組及B'組.在對各組數據進行正態性檢驗及方差齊性分析後,應用重複測量數據的方差分析分彆對A組、B組各時間點的電腦驗光屈光度值及瞳孔直徑進行比較；應用配對t檢驗分彆對A組、B組各時間點電腦驗光屈光度數與A'組、B'組電腦驗光屈光度數進行比較；應用兩組獨立樣本的t檢驗對A組屈光度數的峰值與A'組屈光度數的差值和B組屈光度數的峰值與B'組屈光度數的差值進行比較.結果 A組和B組屈光度數的峰值分彆齣現在1％環噴託酯首次滴眼後50和60 min.A組與A'組屈光度數峰值分彆為(+4.44±2.34)和(+4.86±2.29)D,兩者比較差異有統計學意義(t=11.16,P＜0.01)；B組與B '組屈光度數峰值分彆為(+4.50±2.19)和(+5.04±2.10)D,兩者比較差異有統計學意義(t =11.44,P＜0.01).A組屈光度數峰值與A'組屈光度數間的差異小于B組屈光度數峰值與B '組屈光度數間的差異(t= -1.99,P=0.048).A組和B組瞳孔直徑的峰值分彆齣現在1％環噴託酯首次滴眼後50和60 min,均與其屈光度的峰值時間一緻.結論 在我國3～ 14歲遠視兒童中,單獨應用1％環噴託酯滴眼3次,在首次滴眼後50至70 min驗光可測得其最大的屈光度數；1％環噴託酯聯閤應用錶麵痳醉劑丙美卡因可使其峰值時間提前約10 min,併可增彊1％環噴託酯的睫狀肌痳痺作用.單獨應用1％環噴託酯或丙美卡因與1％環噴託酯聯閤應用,均不能完全代替1％阿託品的睫狀肌痳痺作用.
목적 탐토원시인동응용1％배분탁지적안액이급연합응용표면마취약병미잡인적안액적원시굴광도적봉치시간,병비교응용1％배분탁지여1％아탁품첩상기마비험광적굴광도치적차이.방법 채용간단수궤화분조방법장71례(141지안)원시인동[년령(7.9±2.1)세]분위A조(Pro +Cyc조)화B조(NS+ Cyc조).량조균우1％배분탁지수차적안후30、40、50、60、70 min진행전뇌험광화동공직경측량,1주후급여1％아탁품응효점안,련용3d후중복상술측량,분별위A'조급B'조.재대각조수거진행정태성검험급방차제성분석후,응용중복측량수거적방차분석분별대A조、B조각시간점적전뇌험광굴광도치급동공직경진행비교；응용배대t검험분별대A조、B조각시간점전뇌험광굴광도수여A'조、B'조전뇌험광굴광도수진행비교；응용량조독립양본적t검험대A조굴광도수적봉치여A'조굴광도수적차치화B조굴광도수적봉치여B'조굴광도수적차치진행비교.결과 A조화B조굴광도수적봉치분별출현재1％배분탁지수차적안후50화60 min.A조여A'조굴광도수봉치분별위(+4.44±2.34)화(+4.86±2.29)D,량자비교차이유통계학의의(t=11.16,P＜0.01)；B조여B '조굴광도수봉치분별위(+4.50±2.19)화(+5.04±2.10)D,량자비교차이유통계학의의(t =11.44,P＜0.01).A조굴광도수봉치여A'조굴광도수간적차이소우B조굴광도수봉치여B '조굴광도수간적차이(t= -1.99,P=0.048).A조화B조동공직경적봉치분별출현재1％배분탁지수차적안후50화60 min,균여기굴광도적봉치시간일치.결론 재아국3～ 14세원시인동중,단독응용1％배분탁지적안3차,재수차적안후50지70 min험광가측득기최대적굴광도수；1％배분탁지연합응용표면마취제병미잡인가사기봉치시간제전약10 min,병가증강1％배분탁지적첩상기마비작용.단독응용1％배분탁지혹병미잡인여1％배분탁지연합응용,균불능완전대체1％아탁품적첩상기마비작용.
Objective To investigate the peak time of refractive error obtained by Cyclopentolate Hydrochloride 1.0％ (Cyclopentolate 1.0％ for short ) and Cyclopentolate 1.0％ combined with Proparacaine Hydrochloride 0.5％ (Proxymetacaine) and to compare the refractive error obtained by Cyclopentolate 1.0％ and Atropine 1.0％ in the children with hyperopia.Methods Seventy one children ( 141 eyes) with hyperopia (mean age 7.9 ±2.1 ) were divided into two groups randomly according to the different cycloplegic methods:group A ( Pro + Cyc group) and group B ( NS + Cyc group).There were 34 patients (67 eyes ) in group A and 37 patients (74 eyes ) in group B.One drop of Proparacaine Hydrochloride 0.5％ or physiological saline was used respectively in group A and group B,five minutes before three drops of Cyclopentolate 1.0％ were given at intervals of ten minutes.Cycloplegic autorefractions and pupil diameter were compared at 30,40,50,60,70minutes after the first drop of Cyclopentolate 1.0％was given in both A and B groups.Atropine 1.0％ was used in both groups one week later for three days with three times per day (group A' and group B').Cycloplegic autorefractions and pupil diameter were compared between group A and A,' and group B and B',respectively.Results The peak time of cycloplegic autorefractions was 50 minutes after the first drop of cyclopentolate 1.0％ in group A,while the peak time was 60 minutes in group B.The maximal cycloplegic autorefraction of group A was significantly lower than that in group A' [(+4.44±2.34)D vs.( +4.86±2.26)D,t=11.16,P＜0.01].The maximal cycloplegic autorefraction of group B was significantly lower than that in group B' [ ( + 4.50 ±2.19)D vs.( +5.04 ±2.10) D,t = 11.44,P ＜0.01 ].The difference of cycloplegic autorefractions between group A' and the peak refraction of group A was less than the difference between group B' and the peak refraction of group B[ (0.42 ±0.32) D vs.(0.54 ±0.39) D,t = - 1.99,P =0.048].The peak time of pupil diameter is 50 minutes after the first drop of cyclopentolate 1.0％ in group A,while the peak time of pupil diameter is 60 minutes in group B.The time course of cycloplegic was consistent with mydriasis.Conclusion In 3 to 14 years old Chinese hyperopia children,using cyclopentolate 1.0％ three drops for optometry examination,the maximal cycloplegic autorefractions can be measured from 50 minutes to 70minutes after the first drop of Cyclopentolate 1.0％.The Cyclopentolate 1.0％ can achieve thepeak time of refraction 10 minutes early as well as increase the effect of mydriasis when it is used combined with topical anaesthetic.Cyclopentolate 1.0％ can be used for the optometry examination in the hyperopia children.However neither Cyclopentolate 1.0％ nor Cyclopentolate 1.0％ combined with Proparacaine Hydrochloride 0.5％ can instead of the use of Atropine 1.0％.
