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目的:探讨地塞米松在白内障患者术前结膜囊冲洗中的应用方法和临床效果。方法:将165例(178眼)白内障患者随机分为A组46例(50眼)、B1组40例(42眼)、B2组39例(43眼)、B3组40例(43眼)。A组冲洗液采用庆大霉素8万U+生理盐水至200 ml。B1组、B2组、B3组分别将地塞米松10 mg、20 mg、30 mg加入生理盐水中至200 ml作为冲洗液,比较各组临床效果。结果:B1组、B2组、B3组结膜囊冲洗后,结膜充血、眼部自觉症状、角膜充血和水肿程度明显轻于A组(P<0.05),B2、B3组上述症状发生率明显低于B1组(P<0.05),B2组与B3组比较差异无统计学意义。各组结膜囊冲洗后细菌培养阳性率均较冲洗前显著下降(P<0.05)。结论:白内障患者术前结膜囊冲洗液采用地塞米松+生理盐水配制,临床效果优于庆大霉素+生理盐水,地塞米松20 mg为最适宜剂量。
Objective: To investigate the application and clinical efficacy of dexamethasone in preoperative conjunctival sac irrigation in cataract patients. METHODS: A total of 165 patients (178 eyes) with cataract were randomly divided into group A (46 eyes), group B (40 eyes), group B2 (39 eyes), group B (group B) 40 eyes (43 eyes). A group rinse gentamicin 80,000 U + saline to 200 ml. Group B1, group B2 and group B3, respectively, dexamethasone 10 mg, 20 mg, 30 mg were added to normal saline to 200 ml as a flushing fluid to compare the clinical effects. Results: The conjunctival hyperemia, ocular hypersensitivity, corneal congestion and edema in group B1, group B2 and group B3 were significantly lower than those in group A (P <0.05), while the incidences of the above symptoms in group B2 and group B3 were significantly lower than those in group A B1 group (P <0.05), there was no significant difference between B2 group and B3 group. The positive rate of bacterial culture after the conjunctival sac washing in each group was significantly lower than that before washing (P <0.05). Conclusion: The preoperative conjunctival sac irrigation solution of cataract patients was prepared with dexamethasone + saline. The clinical effect was better than that of gentamicin plus normal saline. Dexamethasone 20 mg was the most suitable dose.