| 摘 要： | 目的 准分子激光上皮下角膜磨镶术(LASEK)后早期使用重组牛碱性成纤维细胞人生长因子(金因舒rhEGF),通过临床观察术后反应,评价外源兴表皮生长因子促进角膜上皮修复的作用.方法 采用随机、双盲、对照的原则,治疗组50例(50眼)均为左眼,采用金因舒+0.1%氟美瞳+0.3%泰利必妥,对照组50例(50眼)均为左眼,单用0.1%氟美瞳+0.3%泰利必.术后观察疼痛、畏光、流泪、异物感、球结膜充血、角膜上皮混浊6项指标.按无、轻、中、重分别记为0、1、2、3分.术后1、2、3、5 d观察术后反应并评分,术后1、2、3周检查视力,术后1、2、3个月观察角膜雾状混浊(Haze)发生情况.第5天开始根据指征尽早取镜.结果 术后第1天和第2天治疗组术后反应较轻,与对照组比较差异有统计学意义(P<0.05).治疗组平均取镜时间为5.5 d,对照组为6.12 d,治疗组早于对照组.两组恢复最佳视力的时间比较差异无统计学意义,术后Haze的发生率和严重程度比较差异无统计学意义.结论 重组人表皮生长因子衍生物能减轻术后早期反应,缩短术后绷带镜片的佩戴时间,安全、无不良反应,有助于LASEK术后角膜上皮化学性和机械性损伤的修复.
Abstract：
Objective To evaluate the effect of ectogenous recombinant human growth factor eye drops(rhEGF) on cutting section corncal epithelium recovery after laser epithelial keratomileusis(LASEK)by observing postoperative inflammation clinically. Methods A randomized, double-blindly,comparison group controlled study enrolled 50 pstients(50eyes,all left eyes) for rhEGF group with therapy of rhEGF+0.1% fluorometholone+0.3% ofloxacin and 50 patients(50eyes,all left eyes) for controlled group with therapy of 0.1% florometholone+0.3% ofloxacin.Observeing pain,photophobia, tearing, foreign body sensation, conjunctival congest and corneal epithelial opacity were observed at 1, 2, 3 and 5 days postoperatively and scored as 0, 1, 2 or 3 respectively according to negative, slight, moderate or severe degree. Visual acuity was measured at 1, 2 and 3 weeks postoperatively. The corneal haze was exanined at 1,2 and 3months postoperatively. The band contact lenses were removed as early as possible from 5 days postoperatively. Results Postoperative inflammation of rhEGF group was significantly slighter than comparison group at 1 and 2 days postoperatively (P<0.05) Average time of removing contact lens was 5.5 days and 6.12 days for treated two group respectively. There was no difference on the time of achieving best visual acuity and haze between two groups. Conclusions rhEGF may relieve early inflammation postoperatively after LASEK and shorten the time of wearing contact lenses, beneficial to epithelium recovery from chemical and machinical injury.
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