糖尿病患者白内障术后泪膜护理防治干眼发生

目的：总结糖尿病患者白内障术后泪膜的护理对防治干眼发生的作用。方法：随机抽取老年性白内障合并糖尿病患者58例（66眼）行超声乳化白内障吸除术，对照组为随机选取的单纯老年性白内障患者50例（50眼）。分别于术前、术后1d、7d、30d进行症状、角膜荧光素染色（FL）、泪膜破裂时间（break—uptime，BUT）、基础泪液分泌试验（SchinmerⅡtest，SIt）调查，并给以相应的护理、防护措施。结果：两组超声乳化白内障吸除术后1d、7d、30d干涩、异物感加重，与术前比较BUT明显缩短，SIt分泌增加，FL染色率也明显增多。差异均有统计学意义（P〈0．01）。两组无论是术前还是术后30dBUT及SIt差异均有统计学意义（P〈0．05）．糖尿病组术后FL染色率明显高于对照组，两组间经x^2检验，差异有统计学意义。结论：糖尿病患者白内障术后可致泪膜稳定性下降，部分患者泪膜比术前更加不稳定。因此术后补充人工泪液，给以特殊对症护理，促使泪膜功能恢复，对糖尿病患者尤为重要。

Nursing of tear film to prevent occurrence of dry eye syndrome following phacoemulsification in diabetics

Objective ：To evaluate tear film changes and dry eye syndrome following phacoemulsication in diabetics. Methods ：This randomized study involved 58 cases （66 eyes） with diabetes cataract and 50 cases （50 eyes） with cataract who underwent phacoemulsification. Tear break-up time（BUT）, Schinmer Ⅱ test （Sit） value and corneal fluorescein staining （FL） were measured preoperatively and 1 d,7d,30d postoperatively. Results：At 1 d,3 d and 7 d postoperatively,the subjective complains of dry eye,the mean Sit and FL scores increased significantly,and the mean BUT decreased significantly （P〈0.01）. In addition,the mean BUT and Sit of diabetes group was less than those of normal group preoperatively and 30 d postoperatively （P〈0.05）. The score of corneal FL of diabetes group was higher than that of normal group. Conclusion： Phacoemulsification reduces the stability of tear film of diabetic patients. Preventions should be taken, like artificial tears.