重症监护病房中暴露性角膜病变的预防
Prevention of exposure keratopathy in intensive care unit.
作者信息
Shan Hua, Min Du
机构信息
Department of Ophthalmology, the First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China.
出版信息
Int J Ophthalmol. 2010;3(4):346-8. doi: 10.3980/j.issn.2222-3959.2010.04.16. Epub 2010 Dec 18.
AIM
To compare the efficacy for preventing exposure keratopathy of three forms of eye care (artificial tear, moist chamber and polyethylene covers) for intensive care patients.
METHODS
Eighty-four patients in Intensive Care Unit (ICU) were randomized to three treatment groups, including artificial tears group, moist chambers group and polyethylene film group. Patients of artificial tear group received two drops of carboxymethylcellulose drops to each eye every 2 hours. The moist chambers and the polyethylene were changed every 12 hours or as needed if they became unclean or torn. The corneal fluorescein stains were performed daily.
RESULTS
No of 28 patients (0%) in the polyethylene group and one of the 27 patients (3.70%) in the moist chamber group had exposure keratopathy, compared to 8 of the 29 patients (27.59%) in the artificial tear group. There were statistical significance between the artificial tear group and the moist chamber group (P=0.02), and the artificial tear group and the polyethylene group (P=0.003). The time on eye care every day of the artificial tear group, the moist chamber group and the polyethylene group was 26.69±2.39 minutes, 35.33±2.63 minutes and 7.48±0.87 minutes, respectively. The eye care of the polyethylene group were statistically more time-save than that of the artificial tear group (P<0.001) and the moist chamber group (P<0.001).
CONCLUSION
Polyethylene covers are more effective and more time-saving in reducing the incidence of corneal damage in intensive care patients.
目的
比较三种眼部护理方式（人工泪液、湿房和聚乙烯眼罩）对重症监护患者暴露性角膜病变的预防效果。
方法
84例重症监护病房（ICU）患者被随机分为三个治疗组，即人工泪液组、湿房组和聚乙烯膜组。人工泪液组患者每2小时每眼滴入2滴羧甲基纤维素滴眼液。湿房和聚乙烯眼罩每12小时更换一次，如有不洁或破损则按需更换。每天进行角膜荧光素染色。
结果
聚乙烯组28例患者中无1例（0%）发生暴露性角膜病变，湿房组27例患者中有1例（3.70%）发生，而人工泪液组29例患者中有8例（27.59%）发生。人工泪液组与湿房组之间（P=0.02）以及人工泪液组与聚乙烯组之间（P=0.003）存在统计学差异。人工泪液组、湿房组和聚乙烯组每天的眼部护理时间分别为26.69±2.39分钟、35.33±2.63分钟和7.48±0.87分钟。聚乙烯组的眼部护理在统计学上比人工泪液组（P<0.001）和湿房组（P<0.001）更节省时间。
结论
聚乙烯眼罩在降低重症监护患者角膜损伤发生率方面更有效且更节省时间。
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