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重症监护病房患者的眼表疾病

Ocular surface disorders in intensive care unit patients.

作者信息

Saritas Tuba Berra, Bozkurt Banu, Simsek Baris, Cakmak Zeynep, Ozdemir Mehmet, Yosunkaya Alper

机构信息

Anesthesiology and Reanimation Department, Meram Medical Faculty, Necmettin Erbakan University, 42080 Konya, Turkey.

出版信息

ScientificWorldJournal. 2013 Oct 29;2013:182038. doi: 10.1155/2013/182038. eCollection 2013.

Abstract

Patients in intensive care units (ICU) are at increased risk of corneal abrasions and infectious keratitis due to poor eyelid closure, decreased blink reflex, and increased exposure to pathogenic microorganisms. The aim of this retrospective study was to evaluate the ocular surface problems in patients who stayed in ICU more than 7 days and were consulted by an ophthalmologist. There were 26 men and 14 women with a mean age of 40.1 ± 18.15 years (range 17-74 years). Conjunctiva hyperemia, mucopurulent or purulent secretion, corneal staining, and corneal filaments were observed in 56.25%, 36.25%, 15%, and 5% of the eyes, respectively. Keratitis was observed in 4 patients (10%) who were treated successfully with topical antibiotics. Mean Schirmers test results were 7.6 ± 5.7 mm/5 min (median 6.5 mm/5 min) in the right, and 7.9 ± 6.3 mm/5 min (median 7 mm/5 min) in the left eyes. Schirmers test results were <5 mm/5 min in 40% of the subjects. The parameters did not show statistically significant difference according to mechanical ventilation, sedation, and use of inotropes. As ICU patients are more susceptible to develop dry eye, keratopathy, and ocular infections, they should be consulted by an ophthalmologist for early diagnosis of ocular surface disorders.

摘要

重症监护病房(ICU)的患者由于眼睑闭合不佳、眨眼反射减弱以及接触致病微生物的机会增加,发生角膜擦伤和感染性角膜炎的风险更高。这项回顾性研究的目的是评估在ICU住院超过7天并接受眼科医生会诊的患者的眼表问题。研究对象包括26名男性和14名女性,平均年龄为40.1±18.15岁(范围17 - 74岁)。分别有56.25%、36.25%、15%和5%的眼睛观察到结膜充血、黏液脓性或脓性分泌物、角膜染色和角膜丝状物。4例患者(10%)发生角膜炎,经局部抗生素治疗成功。右眼平均泪液分泌试验结果为7.6±5.7毫米/5分钟(中位数6.5毫米/5分钟),左眼为7.9±6.3毫米/5分钟(中位数7毫米/5分钟)。40%的受试者泪液分泌试验结果<5毫米/5分钟。根据机械通气、镇静和使用血管活性药物情况,这些参数未显示出统计学上的显著差异。由于ICU患者更容易发生干眼症、角膜病变和眼部感染,应请眼科医生会诊以便早期诊断眼表疾病。

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