摘要
目的 探讨散光检查前三步法宣教指导对白内障患者角膜散光测量的影响。方法 纳入2023年5月至2024年2月于上海市眼病防治中心就诊，伴有角膜规则散光的白内障患者，将患者随机分为对照组和实验组。对照组进行常规IOLMaster700和屈光分析仪 OPD-Scan Ⅲ常规检查，实验组在进行三步法宣教指导后进行IOLMaster700和OPD-Scan Ⅲ检查，比较两组患者检查配合度、检查所需时间和两项检查结果中散光轴位的差异值。结果 纳入研究共138例138眼。实验组较对照组检查配合度高（U=15.47，P=0.0004），检查所需时间更短（t=4.32，P＜0.0001），散光轴位差异值更小（t=2.01，P=0.046），差异均具有统计学意义（P＜0.05）。结论 散光检查前三步法宣教指导有助于提高患者检查过程的配合度，减少检查时间，提高不同检查设备间散光轴位的一致性，可以为临床医生提供更可靠的检查报告。
关键词： 三步法宣教指导；角膜规则散光；散光轴位；白内障
Abstract
Objective To investigate the influence of the first three steps of astigmatism examination on the measurement of corneal astigmatism in cataract patients. Methods Cataract patients with corneal regular astigmatism treated in Shanghai Eye Disease Prevention and Control Center from May 2023 to February 2024 were included and randomly divided into control group and experimental group. The control group underwent routine IOLMaster700 and OPD-Scan III examinations, while the experimental group underwent IOLMaster700 and OPD-Scan III examinations after the three-step education instruction. The cooperation degree of the examination, the time required for the examination and the difference of the astigmatism axis in the two examination results were compared between the two groups. Results A total of 138 patients and 138 eyes were included in the study. Compared with the control group, the experimental group had higher examination cooperation (U=15.47, P=0.0004), shorter examination time (t=4.32, P < 0.0001), and smaller difference in astigmatism axis (t=2.01, P=0.046), with statistical significance (P < 0.05). Conclusion The first three steps of the astigmatism examination can help improve the cooperation of patients during the examination, reduce the examination time, improve the consistency of the astigmatism axis between different examination devices, and provide more reliable examination reports for clinicians.
Key words： Three-step education and guidance; Corneal astigmatism; Astigmatism axis; Cataract
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