河北医药
河北醫藥
하북의약
HEBEI MEDICAL JOURNAL
2014年
3期
336-338
,共3页
刘婕%赵娴%邵丽静%左建霞%王姝蕊%马新玲
劉婕%趙嫻%邵麗靜%左建霞%王姝蕊%馬新玲
류첩%조한%소려정%좌건하%왕주예%마신령
白内障%糖尿病%超声乳化手术%角膜内皮细胞%肾上腺素
白內障%糖尿病%超聲乳化手術%角膜內皮細胞%腎上腺素
백내장%당뇨병%초성유화수술%각막내피세포%신상선소
cataract%diabetes mellitus%phacoemulsification%corneal endothelium%epinephrine
目的：观察不同浓度肾上腺素对糖尿病并发白内障患者行超声乳化白内障吸除术后角膜内皮细胞的影响，探讨术中应用肾上腺素的合理浓度。方法选取2013年1至6月糖尿病性白内障患者90例（90眼），随机分为3组，每组30眼，分别于灌注液中加入0．1 ml、0．2 ml及0．5 ml肾上腺素，均行白内障超声乳化吸除联合人工晶体植入手术，于术前及术后1周采用非接触型角膜内皮显微镜行角膜内皮细胞密度及六角形细胞比例检查。结果3组术前角膜内皮细胞密度及六角形细胞比例比较，差异无统计学意义（ P ＞0．05）。3组术后1周角膜内皮细胞密度分别为（2494±286）/mm 2，（2428±353）/mm 2，（2380±375）/mm 2，六角形细胞比例分别为（49±13）/mm 2，（45±13）/mm 2，（43±14）/mm 2。3组术后角膜内皮细胞密度及六角形细胞比例均较术前减少，其差异均有统计学意义（ P＜0．05）。术后3组间比较，随加入肾上腺素浓度增加，角膜内皮细胞密度及六角形细胞比例逐渐下降，但差异无统计学意义（ P ＞0．05）。结论糖尿病性白内障患者角膜内皮细胞对手术损伤及肾上腺素毒性损害的耐受性降低，在有效维持术中瞳孔散大状态的同时，选用浓度较低的肾上腺素，以减少对角膜内皮细胞的损害。
目的：觀察不同濃度腎上腺素對糖尿病併髮白內障患者行超聲乳化白內障吸除術後角膜內皮細胞的影響，探討術中應用腎上腺素的閤理濃度。方法選取2013年1至6月糖尿病性白內障患者90例（90眼），隨機分為3組，每組30眼，分彆于灌註液中加入0．1 ml、0．2 ml及0．5 ml腎上腺素，均行白內障超聲乳化吸除聯閤人工晶體植入手術，于術前及術後1週採用非接觸型角膜內皮顯微鏡行角膜內皮細胞密度及六角形細胞比例檢查。結果3組術前角膜內皮細胞密度及六角形細胞比例比較，差異無統計學意義（ P ＞0．05）。3組術後1週角膜內皮細胞密度分彆為（2494±286）/mm 2，（2428±353）/mm 2，（2380±375）/mm 2，六角形細胞比例分彆為（49±13）/mm 2，（45±13）/mm 2，（43±14）/mm 2。3組術後角膜內皮細胞密度及六角形細胞比例均較術前減少，其差異均有統計學意義（ P＜0．05）。術後3組間比較，隨加入腎上腺素濃度增加，角膜內皮細胞密度及六角形細胞比例逐漸下降，但差異無統計學意義（ P ＞0．05）。結論糖尿病性白內障患者角膜內皮細胞對手術損傷及腎上腺素毒性損害的耐受性降低，在有效維持術中瞳孔散大狀態的同時，選用濃度較低的腎上腺素，以減少對角膜內皮細胞的損害。
목적：관찰불동농도신상선소대당뇨병병발백내장환자행초성유화백내장흡제술후각막내피세포적영향，탐토술중응용신상선소적합리농도。방법선취2013년1지6월당뇨병성백내장환자90례（90안），수궤분위3조，매조30안，분별우관주액중가입0．1 ml、0．2 ml급0．5 ml신상선소，균행백내장초성유화흡제연합인공정체식입수술，우술전급술후1주채용비접촉형각막내피현미경행각막내피세포밀도급륙각형세포비례검사。결과3조술전각막내피세포밀도급륙각형세포비례비교，차이무통계학의의（ P ＞0．05）。3조술후1주각막내피세포밀도분별위（2494±286）/mm 2，（2428±353）/mm 2，（2380±375）/mm 2，륙각형세포비례분별위（49±13）/mm 2，（45±13）/mm 2，（43±14）/mm 2。3조술후각막내피세포밀도급륙각형세포비례균교술전감소，기차이균유통계학의의（ P＜0．05）。술후3조간비교，수가입신상선소농도증가，각막내피세포밀도급륙각형세포비례축점하강，단차이무통계학의의（ P ＞0．05）。결론당뇨병성백내장환자각막내피세포대수술손상급신상선소독성손해적내수성강저，재유효유지술중동공산대상태적동시，선용농도교저적신상선소，이감소대각막내피세포적손해。
Objective To investigate the effects of adrenalin on corneal endothelium after phacoemulsification in patients with diabetic cataract and to explore the clinical suitable concentration of adrenalin during the operation .Methods Ninety patients with diabetic cataract (90 eyes) who were enrolled in our hospital from January 2013 to June 2013 were randomly divided into three groups,with 30 eyes in each group.These patients received phacoemulsification after the irrigation solution was added with different concentrations of adrenalin (0.1ml,0.2ml,0.5ml).At 1 week before and after the operation the corneal endothelial density and the percentage of hexagonal cells were detected by non -contact corneal endothelium microscope.Results There were no significant differences in the preoperative corneal endothelial cell density and percentage of hexagonal cells among the three groups ( P >0.05).However one week after surgery ,the cell densities in 0.1ml group, 0 .2 ml group and 0.5 ml group were (2493.52 ±285.32)/mm 2 ,(2428.14 ±353.53)/mm 2 ,(2379.51 ±375.13)/mm 2 , respectively,and the percentage of hexagonal cells was (48.88 ±13.13)/mm 2 , (44.77 ±12.67 )/mm 2 , ( 43.44 ± 13.99)/mm 2 ,respectively.Both cell density and percentage of hexagonal cells one week after surgery were significantly lower than those before operation, there were significant differences among three groups ( P <0.05).After operation the two detection parameters in three groups were gradually decreased with the increase of adrenalin concentration ,but there were no significant differences among three groups ( P >0.05).Conclusion The tolerance of corneal endothelial cell to surgery injure and adrenalin toxicity is decreased in patients with diabetic cataract .The lower concentration of adrenalin should be used in phacoemulsification so as to reduce the damage to corneal endothelial cell during maintaining mydriasis state .
