翼状胬肉切除对泪液功能的影响  

Tear functions in patients with pterygium before and after pterygial excision

作　　者：黎明[1] 林跃生[1] 张梅[1] 刘祖国[1] 肖启国[1] 朱晓波[1] 宋书华[1] 林健贤[1] 陈家祺[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中国实用眼科杂志》2004年第9期701-705,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的　客观评价翼状胬肉患者术前、术后的泪液功能情况。方法　对 72例 ( 72只眼 )翼状胬肉患者 ,于翼状胬肉切除术前、术后行泪膜破裂时间 (BUT)、泪液分泌 (Schirmer)Ⅰ试验、泪液羊齿状试验 (TFT)和结膜印迹细胞学检查 ,以评价患者术前、术后的泪液功能。结果　翼状胬肉患者术后 1月的泪液羊齿状试验结果、BUT和结膜杯状细胞数量较术前显著改变 ,具有统计学差异。术后 1月BUT ( 11 5 0± 3 74)s较术前 ( 9 76± 3 3 8)s延长 (P <0 0 5 ) ;术前羊齿状试验结果正常 (Ⅰ级和Ⅱ级 )的患者占 19 44 % ( 14 / 72 ) ,术后 1月Ⅰ级和Ⅱ级的患者增加至 90 2 8% ( 65 /72 ) ,进行Ridit分析 ,术后 1月TFT较术前明显改善 (P <0 0 5 ) ;术前结膜杯状细胞密度为 ( 3 9 73± 18 46)个 / 10个高倍镜 ,术后杯状细胞密度增加 ,为 ( 4 8 85± 18 80 )个 / 10个高倍镜 ,差异有显著意义 (r =6 5 8,P <0 0 5 )。泪液分泌Ⅰ试验结果术前、术后差异无显著意义 (P >0 0 5 )。结论　翼状胬肉患者手术切除前后的泪液功能明显有改变 ,翼状胬肉切除术可使患者的泪液功能得到一定的恢复 ,其原因可能主要与结膜杯状细胞密度增加、粘蛋白分泌功能的恢复有关。Objective To evaluate the tear function in patients with pterygium.Methods Tear break-up time(BUT),Schirmer I test,tear fern test(TFT) and conjunctival impression cytology were evaluated in 72 patients(72 eyes) suffered from pterygium before and after pterygial excision.Results The results of BUT,FTF and conjunctival goblet cells density were significant different before and after pterygial excision.When compared with the BUT before surgery(9.76±3.38)s,BUT prolonged significantly one month after surgery(11.50±3.74)s(q-test,P<0.05).Before surgery,only 19.44% of the patients showed normal crystallization in TFT,and the ratio increased significantly to 90.28% one month after surgery(Ridit analysis,P<0.05).The mean globlet cell density in conjunctival impression specimens was(39.73±18.46)/10 fields before surgery,and the globlet cell density increased significantly one month after surgery(48.85±18.80/10 fields)(t=6.58,P<0.05).No significant difference was found in Schirmer I test before and after surgery(P>0.05).Conclusions Tear function in patients with pterygium is significant different before and after pterygial excision.Pterygial excision can partly restore the tear functions into normal state in patients with pterygium.This may due to the increasing density of the conjunctival goblet cell and the recovery of mucus secretion.

关 键 词：术前 泪液 患者 术后 翼状胬肉 结膜 杯状细胞 BUT 结论 差异 

分 类 号：R777[医药卫生—眼科] R735[医药卫生—临床医学]