老年年龄相关性白内障患者术后泪膜稳定性的影响因素分析

Analysis of influencing factors of tear film stability in elderly patients with age-related cataract after surgery

中文关键词: 老年, 年龄相关性白内障, 超声乳化吸除术, 泪膜稳定性, 影响因素

英文关键词: elderly  age-related cataract  phacoemulsification aspiration  tear film stability  influencing factor

中文摘要:

      目的 分析年龄相关性白内障老年患者术后泪膜稳定性的影响因素,为临床老年患者预后的改善提供参考.方法 回顾性分析2021年6月-2023年6月在海军军医大学第一附属医院接受手术治疗的140例老年年龄相关性白内障患者的临床资料,依据患者术后3个月回院复查泪膜破裂时间情况将其分为泪膜稳定组和泪膜不稳定组.记录患者临床基线资料和手术情况,采用单因素和二元Logistic回归方法分析影响年龄相关性白内障患者术后泪膜稳定性的相关因素.结果 泪膜稳定组和泪膜不稳定组患者年龄、病程、晶状体核硬度、手术切口位置、超声累积释放能量、合并心脏病、合并高血压、睑板腺功能障碍、翼状胬肉差异均无统计学意义(P＞0.05).泪膜稳定组和泪膜不稳定组患者超声乳化时间、病情严重程度、合并糖尿病、单日视觉终端使用时间、结膜松弛分级、睑脂黏度分级差异均有统计学意义(P＜0.05).多因素分析显示,结膜松弛分级(OR=5.48)、睑脂黏度分级(OR=3.57)、超声乳化时间≥20 min(OR=2.70、病情严重程度(OR=1.78)、合并糖尿病(OR=4.55)、单日视觉终端使用时间≥2 h(OR=2.31)为患者术后泪膜不稳定的影响因素(P＜0.05).结论 结膜松弛分级、睑脂黏度分级、超声乳化时间≥20 min、病情严重程度、合并糖尿病、单日视觉终端使用时间≥2 h可能是影响老年患者术后泪膜不稳定的影响因素.

英文摘要:

      Objective To analyze the influencing factors of tear film stability in elderly patients with age-related cata-ract after surgery,and provide reference for improving the prognosis of elderly patients in clinical practice.Methods The clin-ical data of 140 elderly patients with age-related cataract who received surgical treatment in Changhai Hospital Affiliated to Na-val Medical University from June 2021 to June 2023 were retrospectively analyzed.According to the time of tear film rupture at the 3-month follow-up after surgery,patients were divided into stable tear film group and unstable tear film group.Their clini-cal baseline data and surgical conditions were recorded.Univariate and binary logistic regression analysis was performed to ana-lyze the related factors affecting postoperative tear film stability in patients with age-related cataract.Results There was no statistically significant difference in age,disease duration,lens nucleus hardness,surgical incision location,ultrasound cumula-tive energy release,comorbidities of heart disease,hypertension,meibomian gland dysfunction and pterygium between the two groups(P＞0.05).There were significant differences in phacoemulsification time,severity of disease,diabetes mellitus,sin-gle-day visual terminal use time,conjunctival relaxation grade and palpebral lipid viscosity grade between the two groups(P＜0.05).Multivariate analysis showed that the conjunctival relaxation grade(OR=5.48),palpebral lipid viscosity grade(OR=3.57),phacoemulsification time ≥ 20 min(OR=2.70),severity of disease(OR=1.78),diabetes mellitus(OR=4.55),and single-day visual terminal use time ≥2 h(OR=2.31)were the influencing factors for tear film instability after surgery(P＜0.05).Conclusion The conjunctival relaxation grade,palpebral lipid viscosity grade,phacoemulsification time≥20 min,severity of disease,diabetes mellitus,and single-day visual terminal use time ≥2 h may be the influencing factors for postoperative tear film instability in elderly patients.