本文選題：角膜切削術(shù)　切入點(diǎn)：上皮下　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過(guò)對(duì)經(jīng)角膜上皮的激光角膜切削術(shù)(TransPRK)術(shù)后疼痛、異物感、角膜上皮愈合情況、裸眼視力、殘余等效球鏡度等指標(biāo)的觀察,分別評(píng)價(jià)重組人表皮生長(zhǎng)因子滴眼液(rhEGF)應(yīng)用于TransPRK的臨床療效,為TransPRK術(shù)后的合理治療提供參考依據(jù)。方法:選擇2015年06月至2015年12月在我院行雙眼TransPRK患者,共60例(120只眼),其中女性29例(58只眼),男性31例(62只眼)。將符合入選標(biāo)準(zhǔn)的患者隨機(jī)分成試驗(yàn)組和對(duì)照組。術(shù)前均行裸眼視力、矯正視力、眼前節(jié)、眼壓、角膜曲率、驗(yàn)光、眼底、pentacam角膜地形圖、角膜厚度、淚膜破裂時(shí)間檢查。手術(shù)者均是同一人,且嚴(yán)格控制手術(shù)室的溫度和濕度,以保證激光機(jī)的性能維持在最佳狀態(tài)。術(shù)后試驗(yàn)組在常規(guī)用藥(0.5%左氧氟沙星滴眼液、0.1%氟米龍滴眼液)的基礎(chǔ)上加用重組人表皮生長(zhǎng)因子滴眼液,對(duì)照組常規(guī)用藥。術(shù)后分別于1d、2d、3d、1m、2m、3m時(shí)分別評(píng)價(jià)疼痛、異物感、角膜上皮愈合情況、裸眼視力、角膜上皮下霧狀混濁(Haze)、殘余等效球鏡度(MRSE)指標(biāo)。數(shù)據(jù)資料采用±s表示,運(yùn)用SPSS 16.0軟件對(duì)數(shù)據(jù)進(jìn)行分析,兩組數(shù)據(jù)采用重復(fù)測(cè)量數(shù)據(jù)的方差分析。結(jié)果:1、除角膜上皮下霧狀混濁(Haze)指標(biāo)外,其它指標(biāo)的時(shí)間差異性均有統(tǒng)計(jì)學(xué)意義(P0.05)。2、兩組間疼痛、角膜上皮愈合在2d、3d有顯著差異(Pα'),試驗(yàn)組評(píng)分均低于對(duì)照組評(píng)分;裸眼視力指標(biāo)在2d、3d有差異(Pα'),且試驗(yàn)組評(píng)分均高于對(duì)照組評(píng)分;其它觀察指標(biāo)均無(wú)統(tǒng)計(jì)學(xué)差異。結(jié)論:1、兩組的觀察指標(biāo)(除Haze外)均受時(shí)間的影響,且隨著時(shí)間的推移而逐漸好轉(zhuǎn)。2、重組人表皮生長(zhǎng)因子滴眼液能夠改善早期TransPRK術(shù)后患者的部分疼痛癥狀,能夠促進(jìn)角膜上皮的愈合,提高早期視力,對(duì)異物感、Haze、MRSE均無(wú)影響。
[Abstract]:Objective: to observe the indexes of pain, foreign body sensation, corneal epithelium healing, naked eyesight, residual equivalent ball endoscopy and so on after TransPRK. To evaluate the clinical efficacy of recombinant human epidermal growth factor eye drops (rhEGF) in the treatment of TransPRK, and to provide reference for reasonable treatment after TransPRK. Methods: from June 2015 to December 2015, patients with binocular TransPRK were selected in our hospital. A total of 120 eyes were found in 60 cases, of which 29 were female (58 eyes) and 31 male (62 eyes). The patients who met the criteria were randomly divided into two groups: the uncorrected visual acuity, corrected visual acuity, anterior segment, intraocular pressure, corneal curvature and optometry. Pentacam corneal topography, corneal thickness, tear film rupture time examination. The operation is the same person, and the temperature and humidity of the operating room are strictly controlled. In order to keep the performance of laser machine in the best condition, the experimental group was treated with recombinant human epidermal growth factor eye drops on the basis of 0.5% levofloxacin eye drops and 0.1% flumilon eye drops. In the control group, pain, foreign body sensation, corneal epithelium healing, uncorrected visual acuity, haze in the subcutaneous haze of cornea, and MRSEs were evaluated at 1 day, 2 days and 3 days after operation, respectively. The data were expressed as 鹵s. SPSS 16.0 software was used to analyze the data. Two groups of data were analyzed by the analysis of variance of repeated measurement data. Results: 1. The time difference of other indexes, except for the index of corneal hypodermic haze, was statistically significant (P0.05 路2), and the pain between the two groups was significant. There was significant difference in corneal epithelial healing on the 2nd day and 3rd day, and the scores of the experimental group were lower than those of the control group, and the visual acuity index of the naked eye was different on the 3rd day of the second day, and the score of the test group was higher than that of the control group. Conclusion the observation indexes (except Haze) of the two groups were affected by time. With the passage of time, recombinant human epidermal growth factor eye drops can improve some pain symptoms, promote corneal epithelial healing, improve early visual acuity, and have no effect on foreign body sensation.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R779.63
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本文編號(hào)：1576174