双氯芬酸钠联合维生素C治疗 TPRK术后不适症状

doi:10.3760/cma.j.issn.1674-845X.2019.11.004

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摘要

目的：评估双氯芬酸钠滴眼液联合口服维生素C缓解经上皮准分子激光角膜切削术（TPRK）术后不适症状的临床效果。方法：前瞻性随机对照研究。选取2018年2—6月在青岛眼科医院行TPRK患者70例，分为观察组和对照组，每组35例，观察组除了给予双氯芬酸钠滴眼液联合口服维生素C之外，其余处理同对照组，于术后第1天、第3天或第4天观察症状和体征，对眼部刺激症状进行问卷评分，包括疼痛感、异物感、流泪、畏光、睁眼不适等情况。采用独立样本t检验或重复测量方差分析进行统计学处理。结果：术后疼痛感、异物感、流泪等在2组间差异均有统计学意义（F=10.219， P=0.002；F=8.637，P=0.005；F=5.108，P=0.027），术后当日及术后1 d上述指标在2组间差异有统计学意义（P<0.05），至术后2 d时差异无统计学意义。畏光、睁眼不适感在2组间差异无统计学意义（F=3.626，P=0.061；F=2.778，P=0.100），眼部总体不适感2组间差异有统计学意义（F=7.785， P=0.001）。结论：双氯芬酸钠滴眼液联合口服维生素C可以较为简单安全地控制TPRK术后的疼痛感，减轻患者的不适感觉。

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关键词 ：经上皮准分子激光角膜切削术, 双氯芬酸钠, 维生素C, 疼痛感, 异物感

Abstract：

Objective: To evaluate the clinical effect of diclofenac sodium combined with vitamin C to relieve discomfort after transepithelial photorefractive keratometry (TPRK). Methods: In this randomized control trial, seventy patients undergoing TPRK surgery were recruited from February to June 2018 and divided into observation group and control group, with 35 patients in each group. The observation group was treated with diclofenac sodium eyedrops combined with oral vitamin C, and the control group was treated only with diclofenac sodium eye drops. Symptoms and signs were observed on day 1, day 3 and day 4 after surgery, and eye irritation symptoms were evaluated by a questionnaire, including pain, foreign body feelings, tearing, photophobia, and discomfort in blinking. The results were analyzed with an unpaired t test and repeated measures ANOVA. Results: There were statistically significant differences between the two groups (pain score: F=10.219, P=0.002; foreign body feelings score: F=8.637, P=0.005; tearing: F=5.108, P=0.027. Repeated measures ANOVA). There were statistically significant differences for the above scores between the two groups on day 0 and day 1 after surgery (all P<0.05), but no statistically significant differences on day 2. The differences between the two groups were not statistically significant (photophobia score: F=3.626, P=0.061; discomfort score in blinking: F=2.778, P=0.100). But there were statistically significant differences between the two groups in the total discomfort score (F=7.785, P=0.001). Conclusion: Diclofenac sodium combined with vitamin C can relieve pain after TPRK surgery and reduce discomfort in patients.

Key words： transepithelial photorefractive keratectomy diclofenac sodium vitamin C pain foreign body feeling

收稿日期: 2019-02-19

基金资助:

山东省医药卫生科技发展计划项目（2017WS180）

通讯作者: 龙克利（ORCID：0000-0003-2501-0937），Email：longkeli2002@aliyun.com

引用本文:

王海燕冯青青张嘉璠丁雯芝彭予苏龙克利. 双氯芬酸钠联合维生素C治疗 TPRK术后不适症状[J]. 中华眼视光学与视觉科学杂志, 2019, 21(11): 820-825. Haiyan Wang, Qingqing Feng, Jiafan Zhang, Wenzhi Ding, Yusu Peng, Keli Long. The Effect of Diclofenac Sodium Combined with Vitamin C for Relieving Discomfort after TPRK. Chinese Journal of Optometry Ophthalmology and Visual science, 2019, 21(11): 820-825. DOI: 10.3760/cma.j.issn.1674-845X.2019.11.004

链接本文:

https://www.cjoovs.com/CN/10.3760/cma.j.issn.1674-845X.2019.11.004 或 https://www.cjoovs.com/CN/Y2019/V21/I11/820

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