本文選題：阿托品 + 防治��； 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]阿托品是目前控制青少年近視公認(rèn)的比較有效的藥物,但長期高頻率點眼帶來的副作用使得阿托品的臨床使用受限,本研究旨在探討間斷使用1%阿托品眼用凝膠對青少年近視防治的有效性和安全性,以期能夠探索最低使用頻率控制近視進展的用藥方法。[方法]收集2015年07月至2016年01月于昆明醫(yī)科大學(xué)第四附屬醫(yī)院(云南省第二人民醫(yī)院)兒童眼科門診就診的確診為中低度近視、且符合納入標(biāo)準(zhǔn)的患兒102例,分為A治療組,平均年齡10.77±1.69歲,男13例,女17例,40眼(單眼或雙眼近視度數(shù)為-0.50DS或-0.75DS,阿托品眼用凝膠用四周,即第一周點兩次,第二周點一次,第三、四周停用);B治療組平均年齡10.97±1.67歲,男16例,女14例,60眼(雙眼近視,一月法,雙眼交替使用,開始點右眼一次兩周后點左眼一次,依次類推);C治療組,平均年齡14.95±0.83歲,男11例,女9例,40眼(雙眼近視,兩月法,雙眼交替使用,開始點右眼一次一月后點左眼一次,依次類推);對照D組,平均年齡10.64±1.73歲,男10例,女12例,44眼(雙眼近視,常規(guī)驗光戴鏡);B、C、D組患者雙眼近視度數(shù)≥-1.00DS,≤-6.00 D,散光≤-1.00 D。A組患兒一月后觀察記錄屈光度、眼軸、視力、眼壓的變化。B、C組患兒根據(jù)視力和癥狀給予常規(guī)驗光配鏡觀察,所有患者在受試前均接受全面的眼科檢查作為基線標(biāo)準(zhǔn),1年后觀察各組屈光度、眼軸、視力、眼壓的變化,比較相關(guān)數(shù)據(jù)進行統(tǒng)計分析。[結(jié)果]A組26例(86.67%)33眼完成了一月的觀察治療,一月后近視屈光度變化(0.16±0.27)D,眼軸增長為(0.002±0.26)mm;B、C、D 四組共 64 例(85.00%)完成了 1年的觀察,其中B組26例52眼,C組16例32眼,D組22例44眼,經(jīng)過一年左右觀察,3組近視屈光度進展分別為(-0.39±0.28)D、(-0.47±0.17)D 和(-0.97±0.21)D;眼軸增長分別為(0.14±0.08)mm、(0.19±0.12)mm和(0.39±0.10)mm。B組和對照D組屈光度、眼軸長度變化有統(tǒng)計學(xué)意義(P0.05)。B組兒童點阿托品后單眼近視力達(dá)1.0平均需4.5天,畏光癥狀消失需4.4天。各組患兒眼壓變化無統(tǒng)計學(xué)意義(P0.05),所有觀察對象均未出現(xiàn)眼壓顯著升高。[結(jié)論]1.間斷使用1%阿托品對控制中低度近視進展有效。2.1%阿托品間斷交替點眼患兒無明顯視近困難。3.1%阿托品間斷使用對患兒眼壓無明顯影響。4.長期間斷交替使用1%阿托品兒童耐受良好,醫(yī)從性較高,是較適宜的給藥方式。
[Abstract]:[objective] Atropine is an effective drug for the control of juvenile myopia, but the side effects of long-term high frequency point eye make the clinical use of atropine limited.The purpose of this study was to investigate the efficacy and safety of intermittent use of 1% atropine ophthalmic gel in the prevention and treatment of juvenile myopia, and to explore the method of using the lowest frequency to control the progression of myopia.[methods] from July 2015 to January 2016, 102 children who were diagnosed as moderate and low myopia at the fourth affiliated Hospital of Kunming Medical University (second people's Hospital of Yunnan Province) were divided into two groups.The mean age was 10.77 鹵1.69 years old, male 13 cases, female 17 cases 40 eyes (monocular or binocular myopia degree -0.50 DS or -0.75 DS). Atropine ophthalmic gel was used for four weeks, that is, twice in the first week, once in the second week, and third, the average age in the treatment group was 10.97 鹵1.67 years.There were 16 males and 60 females (binocular myopia, one-month method, alternate use of both eyes, starting point of right eye once a fortnight, point of left eye once, and so on). The average age of treatment group was 14.95 鹵0.83 years old, male 11 cases, female 9 cases 40 eyes (binocular myopia, two-month method).The mean age of group D was 10.64 鹵1.73 years old, male 10 cases and female 12 cases 44 eyes.The changes of diopter, axial vision, visual acuity and intraocular pressure were observed and recorded in group D with routine optometry wearing glasses 鈮，

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