改良和传统睑板腺压榨手法治疗睑板腺功能障碍的比较  

Improved method of meibomian gland compression in the treatment of meibomian gland dysfunction

作　　者：董雪青[1,2] 高莹莹[1] 赵华轩[1] 王凤[1] 庄铭忠[1] 王婷[1] 

机构地区：[1]福建医科大学附属第二医院,362060 [2]泉州解放军第180眼科医院

出　　处：《中国实用眼科杂志》2015年第1期72-77,共6页Chinese Journal of Practical Ophthalmology

基　　金：福建医科大学附属第二医院苗圃基金资助（2012-09-6）

摘　　要：目的改良睑板腺压榨法治疗睑板腺功能障碍（MGD），比较该方法与传统治疗方法在操作、疗效以及对眼表损害的差别。方法选取2012年1～8月在福建医科大学附属第二医院就诊的40例MGD患者，分成2组：改良组20例，采用改良的无需表面麻醉的睑板腺压榨疗法；传统组20例采用传统的睑板腺压榨法。所有患者治疗1周1次，配合每天进行眼睑卫生清洁和热敷，两组患者每Et均点用人丁泪液4次／d，睡前睑缘擦拭妥布霉素地塞米松眼膏，随访2个月。对患者治疗前、后2个月的眼部症状，睑板腺积分、国际眼表疾病指数（OSDI）积分、操作时间、角膜荧光素钠染色（FL）、泪膜破裂时间（BUT）、泪液分泌试验（SIT）以及压榨后睑结膜上皮细胞形态进行观察记录。结果治疗前，传统组和改良组在眼部症状、睑板腺积分、OSDI、FL、BUT、泪液分泌试验上均差别无统计学意义（P〉0．05）；治疗后，传统组和改良组SIT、FL比治疗前均有不同程度的改善差异有统计学意义（P〈O．05），特别是BUT明显延长，睑板腺积分、OSDI显著降低，差异有统计学意义（P〈0．01）；组间比较，改良组BUT为（8．75±4．19）s较传统组（5．6±2．11）S明显延长，差异有统计学意义（P〈0．05）。改良组操作时间为（2．5±0．82）min，传统组操作时间为（15±3．5）min，差异显著有统计学意义（t=33．108，P〈0．01）。睑结膜印迹细胞检查显示改良组治疗后的结膜上皮细胞损伤程度明显小于传统组，差异有统计学意义（连续性矫正的x2=27．726，P=0．000）。治疗和随访期内，改良组治疗过程和治疗后无不良反应发生，传统组有3例次日出现结膜充血，分泌物增多，急性结膜炎症状，给予抗生素眼药水后缓解。结论改良和传统的睑板腺压榨疗法均能有效缓解MGD引起的眼部不适，改良压榨法对泪膜�Objective To modify the manipulation method of meibomian compression in the treatment of meibomian gland dysfunction （MGD） and to compare the difference of the improved method and conventional method in the therapeutic effect, operative feasibility and ocular surface damage in MGD treatment. Methods Forty cases of MGD patients were randomly divided into 2 groups, 20 patients who were chosen as the innovative group were treated by improved meibomian gland compression, the other 20 patients were sorted as conventional group and treated with traditional meibomian gland compression. The patients were received meibomian gland compression once a week, with eyelid hygiene and warm compress once daily and artificial tears four times a day, tobra- mycin-dexamethasone eye ointment at bedtime. All measurements were repeated at the 2-months fol- low-up visit. The personal information and past medical history were recorded, ophthalmological check up list including Fluorescein stain test （FL）, Fluorescein tear break-up time （BUT）, Schirmer I Test （SIT）. Tarsal conjunetival impression cytology was applied to study the cytological changes af- ter both method of meibomian compression. Ocular Surface Disease Index （OSDI）, meibomian score were recorded to evaluate the severity of the MGD. Results BUT, FL, SIT, meibomian gland scores and OSDI sores was no difference before treatment in two groups （P 〉0.05）, these objective parameters were significantly improved after 2 months of treatment in two group （P 〈0.05）. The mean BUT in the innovative group prolonged significantly compared with the conventional group （P 〈0.05）. The duration of treatment in conventional group was 15 ± 3.5 minutes which was significantly longer than 2.5 ± 0.82 minutes in innovative group （t =33.108, P 〈0.01）. Tarsal conjunctiva impression cytology showed that epithelial cells in the innovatived group were mostly intact while in conventional group, the morphological changes was great, a large amount of ceils were ne

关 键 词：干眼 睑板腺压榨 改良的睑板腺压榨 国际眼表疾病指数 睑板腺积分 

分 类 号：R442.8[医药卫生—诊断学]