Intensive care unit入院中患者の眼表面障害

Ocular surface lesions in patients staying in intensive care unit

　集中治療部（intensive care unit：ICU）に入院中の患者の眼表面障害の頻度と原因の解明を行った。2003年4～7月まで当院ICUに入院した66例を対象とし，眼表面障害，閉瞼障害，全身管理状態，在室日数を検索した。眼表面の診察には手持ち細隙灯顕微鏡を用いた。その結果，14例17眼に角膜障害があり，その全例に意識障害と閉瞼不全があった。角膜障害例の入院日数は12.9±13.5日で，非障害群の5.2±4.9日と有意差があった（p＝0.037）。結膜浮腫は15例29眼にあり，これと角膜障害の間には関連がなかった。ICUに入院している患者には，閉瞼不全による角膜障害の発症が多い。閉瞼不全例には早期から閉瞼ができる処置をすることが視機能維持に重要である。

　Purpose：To ascertain the incidence and causes of ocular surface lesions in patients in the intensive care unit（ICU）. Cases and Method：We examined 66 patients who were treated in the ICU of our hospital during 4months through July 2003. Particular attention was paid to ocular surface lesion,difficulty in eyelid closure,systemic features,and duration of stay in ICU. A hand-held slitlamp microscope was used in the examination of the outer eye. Results：Corneal lesion was detected in 17 eyes of 14 patients. All had impaired consciousness and lagophthalmos. The duration of stay in the ICU averaged 12.9±13.5 days in patients with corneal involvement and 5.2±4.9 days in those without. The difference was significant（p＝0.037）. Conjunctival edema was present in 29 eyes of 15 patients and was not correlated with corneal lesions. Conclusion：Corneal lesion secondary to lagophthalmos is frequent in patients staying in ICU. Early treatment for lagophthalmos is important to maintain the visual function.