泪阜肿物切除联合结膜固定术治疗功能性溢泪的临床研究  

Caruncular tumor resection combined with conjunctival fixation for functional epiphora patients

作　　者：邵毅[1] 邹晶[1] 余瑶[2] 胡佩宏 李云艳[1] 裴重刚[1] 张颖[1] 涂萍[2] 高桂平[1] 

机构地区：[1]南昌大学第一附属医院眼科,江西省南昌市330006 [2]南方医科大学附属南昌市第三医院内分泌科,江西省南昌市330009

出　　处：《眼科新进展》2015年第4期334-337,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号81160118;81400372);全国临床医药研究专项基金(编号:L2012052);江西省远航工程(编号:2014022);江西省科技平台建设项目(编号:2013116);江西省青年科学基金(编号:20114BAB215036);江西省科技支撑计划项目(编号:20111BBG70026-2);江西省教育厅科技计划项目(编号:GJJ14170);江西省卫计委科技计划项目(编号:20155154)~~

摘　　要：目的探讨功能性溢泪患者泪阜肿物切除术后眼表症状、泪膜和泪液蛋白的特点。方法泪阜肿物导致的功能性溢泪患者60例,随机分为两组:A组行泪阜肿物切除联合结膜固定术;B组行单纯泪阜肿物切除术,分别于术前及术后不同时间对患者行眼表症状评分、泪膜四项检查和泪液各蛋白测定,并对疗效进行对比。结果 A组总有效率为90%,B组为70%,两组比较差异有统计学意义(P<0.05)。术前两组眼表指数、泪膜破裂时间、基础泪液分泌量、泪河高度、角膜荧光素染色及泪液蛋白、乳铁蛋白、溶菌酶和分泌型免疫球蛋白A(sIgA)差异均无统计学意义(均为P>0.05);术后1周,两组患者基础泪液分泌量、泪河高度、角膜荧光素染色比较差异均有统计学意义(均为P<0.05),但两组眼表指数、泪膜破裂时间、泪液总蛋白量、乳铁蛋白、溶菌酶及sIgA比较差异均无统计学意义(均为P>0.05);术后3个月,两组患者眼表指数、泪膜破裂时间、基础泪液分泌量、泪河高度、角膜荧光素染色差异均有统计学意义(均为P<0.05),但两组泪液总蛋白量、乳铁蛋白、溶菌酶及sIgA差异均无统计学意义(均为P>0.05)。结论对于泪阜肿物导致的功能性溢泪患者,泪阜肿物切除联合结膜固定术可以明显改善患者眼表症状、泪膜情况和泪液蛋白含量,提高患者的视觉质量。Objective To observe the symptom of ocular surface,characteristics of tear film and tear protein after caruncular tumor resection combined with conjunctival fixation for functional epiphora patients. Methods Sixty functional epiphora patients（ 60 eyes） caused by caruncular tumor were randomly divided into two groups： Group A received caruncular tumor resection combined with conjunctival fixation,group B received caruncular tumor resection. The tear film and tear protein examination were performed before surgery and 1 week,1 month and3 months after surgery separately. Results Effective rate of group A was 90. 0%and group B were 70. 0%,respectively,there was statistical difference（ P〈0. 05）. There was no significant difference in the ocular surface disease index,break-up time,Schirmer I test,tear meniscus height,fluorescein,tear proteins,lactoferrin,lysozyme and sIgA preoperatively between two groups（ all P〉0. 05）.There were statistical difference in Schirmer I test,tear meniscus height and fluorescein at postoperative 1 week between two groups（ all P〉0. 05）,whereas no statistical difference in ocular surface disease index,break-up time,tear proteins,lactoferrin,lysozyme and sIgA（ all P〉0. 05）. There were statistical difference in ocular surface disease index,break-up time,Schirmer I test,tear meniscus height and fluorescein at postoperative 3 month between two groups（ all P〈0. 05）,whereas no statistical difference in tear proteins,lactoferrin,lysozyme and sIgA（ all P〉0. 05）. Conclusion The caruncular tumor resection combined with conjunctival fixation is a more favorable solution for the functional epiphora patients caused by caruncular tumor,which can stable the tear film,increase the tear protein and therefore improve the visual quality.

关 键 词：功能性溢泪 泪液蛋白 泪阜肿物 泪膜 

分 类 号：R697.21[医药卫生—泌尿科学]