冷敷眼罩用于全激光角膜表层切削术后止痛的效果

摘要

· AlM: To investigate the effects of a cold patch on postoperative pain and other relevant reactions to transepithelial photorefractive keratectomy. n ·METHODS:ln this prospective, randomized controlled study, forty patients ( 80 eyes ) scheduled to undergo transepithelial photorefractive keratectomy for myopia or myopic astigmatism were randomly and equally divided to be treated with iced balanced salt solution during the surgery ( washing group, 20 cases, 40 eyes) or to wear a postoperative cold compress for 24h ( cold compress group, 20 cases, 40 eyes ) .The main outcomes were visual analogue pain score 8, 16, 24h after surgery, postoperative eyelid edema, conjunctival hyperemia, epithelial healing time, Haze, and postoperative best-corrected visual acuity. n · RESULTS: Demographic data and the pain scores during surgery were similar between the two groups. The mean postoperative pain scores of patients in the cold compress group at 8, 16, and 24h were significantly lower than that of the washing group. Scores for postoperative eyelid edema and conjunctival hyperemia in the cold compress group were also lower than in the washing group. Patients in the cold compress group applied fewer painkillers.The epithelium healing time, Haze, and early recovery of visual acuity were similar between the two groups. n · CONCLUSlON: Wearing a cold eye shield after transepithelial photorefractive keratectomy can effectively relieve pain and inflammation and reduce the consumption of painkillers.%目的：评价冷敷眼罩用于全激光角膜表层切削术后止痛、减轻术后反应的临床效果。n　　方法：选取行全激光角膜表层切削术的近视患者40例80眼，随机分成冷敷组和冲洗组两组，每组20例40眼：冷敷组术中不给予冰镇平衡盐溶液冲洗创面，术后给予冷敷眼罩配戴24 h；冲洗组术中以冰镇平衡盐溶液冲洗创面，术后不给予冷敷眼罩。分别记录两组术中、术后8，n　　16，24 h的疼痛分值，术后眼睑水肿、球结膜充血情况以及上皮愈合时间、Haze、术后裸眼视力、最佳矫正视力。结果：冷敷组和冲洗组在术中的疼痛分值无统计学差异，术后8，16，24 h冷敷组疼痛分值均低于冲洗组。冷敷组中术后眼睑水肿、球结膜充血程度均低于冲洗组。在使用止痛药物方面：术后24 h内，冷敷组使用表面麻醉剂点眼总次数和口服双氯芬酸钠胶囊总量均低于冲洗组。在上皮愈合时间、Haze、早期视力恢复方面，两组无统计学差异。n　　结论：全激光角膜表层切削术后应用冷敷眼罩可有效止痛并减轻术后反应，减少止痛药物用量，而且廉价易得、无化学药物的全身及局部副作用。