CAJ | 학술논문

目的：改良Parks切口联合丙美卡因表面麻醉在青少年共同性斜视矫正术中的应用及术后恢复情况的临床观察。方法随机选取55例已在我院行共同性斜视矫正术患者，分为改良组和传统组，其中改良组(n=35)采用改良Parks切口联合丙美卡因表面麻醉手术方式，传统组(n=20)采用传统角膜缘梯型切口联合利多卡因局部麻醉手术方式，观察两组手术麻醉耐受性、术后美容效果及手术前后泪膜稳定情况。对得出的数据进行统计分析。结果丙美卡因表面麻醉与传统手术利多卡因局部麻醉患者耐受性无显著差异(P<0.05)；术后美容效果Parks切口较传统角膜缘梯型切口隐蔽，且恢复快、好，斜视术后正位效果好，差异有统计学意义；荧光素染色泪膜破裂时间(FBUT)及schirmer's玉实验(S1T)术后30 d改良组均好于传统对照组，差异有统计学意义。结论改良术麻醉耐受效果好，对患者的侵入性操作较传统手术少，对正常组织破坏少，术后美容效果好、眼表泪膜功能影响小，值得推广。
목적：개량Parks절구연합병미잡인표면마취재청소년공동성사시교정술중적응용급술후회복정황적림상관찰。방법수궤선취55례이재아원행공동성사시교정술환자，분위개량조화전통조，기중개량조(n=35)채용개량Parks절구연합병미잡인표면마취수술방식，전통조(n=20)채용전통각막연제형절구연합리다잡인국부마취수술방식，관찰량조수술마취내수성、술후미용효과급수술전후루막은정정황。대득출적수거진행통계분석。결과병미잡인표면마취여전통수술리다잡인국부마취환자내수성무현저차이(P<0.05)；술후미용효과Parks절구교전통각막연제형절구은폐，차회복쾌、호，사시술후정위효과호，차이유통계학의의；형광소염색루막파렬시간(FBUT)급schirmer's옥실험(S1T)술후30 d개량조균호우전통대조조，차이유통계학의의。결론개량술마취내수효과호，대환자적침입성조작교전통수술소，대정상조직파배소，술후미용효과호、안표루막공능영향소，치득추엄。
Objective To observe the application of improved Parks incision combined with proparacaine surface anes-thesia in the correction surgery of adolescent concomitant strabismus and the postoperative recovery situation. Methods Fifty-five patients who had received concomitant strabismus correction surgery in our hospital were randomly selected and divided into the improved group and the traditional group, of which the improved group (35 patients) was given the improved Parks incision combined with proparacaine surface anesthesia surgical method and the traditional group (20 patients) was given traditional corneal limbus trapezoid incision combined with lidocaine local anesthesia surgical method. The surgical anesthesia tolerance, postoperative cosmetic results and preoperative and postoperative tear film stability of the two groups were observed. The data were analyzed statistically. Results The patients received propara caine surface anesthesia and the patients received lidocaine local anesthesia were not significantly different in the toler-ance(P>0.05). Regarding to cosmetic results, the Parks incision concealed itself better than the traditional corneal limbus trapezoid incision, and showed faster and better recovery and better postoperative orthotopic effects, with statis-tically significant differences. The improved group was better than the traditional group in the fluorescein staining tear film break-up time (FBUT) and schirmer's Ⅰ experiment (S1T) 30 days after surgery, with statistically significant dif-ferences. Conclusion The improved surgery has better anesthetic tolerance effect, less invasive operation, less damage to normal tissue, better postoperative cosmetic results and smaller influence on ocular surface tear film function than the traditional surgery, thereby worthy of promotion.