CAJ | 학술논문

目的评价超声乳化白内障吸除术后远期泪膜变化情况,并分析其相关的独立危险因素.方法采用自身对照研究,随机选取于上海市交通大学附属第一人民医院眼科行超声乳化白内障吸除术的白内障患者256例(256眼),分别于术前1d及术后3个月时行泪膜破裂时间(BUT)、角膜荧光素基础泪液分泌试验(SIt)、染色积分(FI)的检查,采用独立样本t检验、配对t检验、卡方检验、Mann-Whitney检验、多元线性回归分析、Spearman相关性分析和Pearson相关性分析对数据进行统计学处理.结果共96例患者最终完成了本次研究,除年龄外,96例患者可代表总体256例患者的资料.96例患者自身对照比较的结果显示,术后3个月时各项检测指标均已恢复至术前水平.分析影响术后BUT值、SIt值、FI值水平的危险因素后发现:术后BUT值与术前BUT值呈正相关(r=0.38,P＜0.01),与患者年龄呈负相关(r=-0.22,P=0.02)；术后SIt值仅与术前SIt值呈正相关(r=0.41,P＜0.01)；术后FI值分别与术前BUT值、SIt值呈负相关(r=-0.32,P＜0.01；r=-0.22,P＜0.01),与术前FI值呈正相关(r=-0.35,P=0.01).结论超声乳化白内障吸除术对术后远期泪膜影响小,泪膜各项指标水平的高低主要与术前基础值相关.
목적 평개초성유화백내장흡제술후원기루막변화정황,병분석기상관적독립위험인소.방법 채용자신대조연구,수궤선취우상해시교통대학부속제일인민의원안과행초성유화백내장흡제술적백내장환자256례(256안),분별우술전1d급술후3개월시행루막파렬시간(BUT)、각막형광소기출루액분비시험(SIt)、염색적분(FI)적검사,채용독립양본t검험、배대t검험、잡방검험、Mann-Whitney검험、다원선성회귀분석、Spearman상관성분석화Pearson상관성분석대수거진행통계학처리.결과 공96례환자최종완성료본차연구,제년령외,96례환자가대표총체256례환자적자료.96례환자자신대조비교적결과현시,술후3개월시각항검측지표균이회복지술전수평.분석영향술후BUT치、SIt치、FI치수평적위험인소후발현:술후BUT치여술전BUT치정정상관(r=0.38,P＜0.01),여환자년령정부상관(r=-0.22,P=0.02)；술후SIt치부여술전SIt치정정상관(r=0.41,P＜0.01)；술후FI치분별여술전BUT치、SIt치정부상관(r=-0.32,P＜0.01；r=-0.22,P＜0.01),여술전FI치정정상관(r=-0.35,P=0.01).결론 초성유화백내장흡제술대술후원기루막영향소,루막각항지표수평적고저주요여술전기출치상관.
Objective To evaluate long-term changes of tear film after phacoemulsification surgery.Methods A self controlled study was performed.Two hundred fifty-six cataract patients (256 eyes) underwent phacoemulsification in the Department of Ophthalmology,Shanghai first People's Hospital,Shanghai Jiaotong University,were randomly enrolled in this prospective study.The tear film break up time (BUT),Schirmer I test (SIt),and Fluorenscein integral (FI) were measured 1 day preoperatively and patients were followed up for 3 months postoperatively.Statistical analysis included an independent samples t test,paired t test,chi-square test,Mann-Whitney test,multiple linear regression,Spearman correlation analysis and Pearson correlation analysis.Results Ninety-six patients participated in the 3-month postoperative follow-up period.All the information on the 96 patients and the original 256 patients was consistent,except for their ages.The 3-month postoperative scores of BUT,SIt and FI did not differ from preoperative scores.According to regression analysis,the postoperative BUT scores correlated positively with preoperative BUT scores (r=0.38,P＜0.O1),and correlated negatively with age (r=-0.22,P=0.02).The postoperative Schirmer I test scores correlated positively with preoperative Schirmer I test scores (r=0.41,P＜0.01).The postoperative FI test scores not only correlated positively with preoperative FI test scores (r=0.35,P=0.01),but also correlated negatively with preoperative BUT scores (r=-0.32,P＜0.01) and preoperative SIt scores (r=-0.22,P＜0.01).Conclusion At 3 month after phacoemulsification,the results of objective tear film examinations show a return to preoperative levels.