目的:比较分析三种眼部治疗方法(人工泪液、湿房和敷贴)对于重症监护患者发生暴露性角膜炎的有效性。方法:将重症监护室(ICU)患者随机分为3组:人工泪液组、湿房组和敷贴组。人工泪液组患者每2h行2滴羧甲基纤维素钠眼药水点眼。湿房组和敷贴组患者每12h更换湿房和敷贴一次或污染及损坏时更换。每天进行角膜荧光素染色观察角膜状态。结果:在敷贴组28例患者中,无暴露性角膜炎发生;湿房组27例患者中,1例(4%)患者发生暴露性角膜炎;而人工泪液组29例患者中,8例(28%)发生了暴露性角膜炎。暴露性角膜炎的发生率,人工泪液组与湿房组(P=0.02)和敷贴组(P=0.003)比较有显著性差异。每日眼部护理所需时间在人工泪液组、湿房组和敷贴组分别是26.69±2.39,35.33±2.63和7.48±0.87min;与人工泪液组和湿房组相比较,敷贴组更省时。结论:在重症监护患者暴露性角膜炎的防治上,敷贴方法更有效、更省时。

·AIM:To compare the efficacy of three types of eye care(artificial tear,moist chamber and polyethylene covers)for preventing exposure keratopathy in intensive care patients.·METHODS:Intensive Care Unit(ICU)patients were randomly divided to three treatment groups,including artificial tear group(29 cases),moist chamber group(27 cases)and polyethylene covers group(28 cases).Patients in artificial tear group received two drops of carboxymethylcellulose dropped to each eye every 2 hours.The moist chamber and polyethylene covers groups were changed every 12 hours or as needed if they became unclean or torn.Corneal fluorescein stain was performed daily.·RESULTS:No one in the polyethylene covers group and one case(4%)in the moist chamber group had exposure keratopathy compared to 8 cases(28%)in the artificial tear group.There were statistical significance differences between both artificial tear group and moist chamber group(P=0.02),artificial tear group and polyethylene covers group(P=0.003).Everyday time of eye care in the artificial tear group,the moist chamber group and the polyethylene covers group was respectively 26.69±2.39,35.33±2.63 and 7.48±0.87 minutes.Everyday time of eye care in the polyethylene covers group was statistically more time-saving than that in the artificial tear group(P<0.01)and the moist chamber group(P<0.01).·CONCLUSION:Polyethylene covers are more effective and time-saving in reducing the incidence of corneal damage in intensive care patients.·

R772.21