颞侧球结膜眼红指数、眼部症状评分、视觉模拟量表评分在翼状胬肉切除联合自体结膜移植术后眼表炎症状态评价中的应用研究  

Application of TCHI,OSS and VAS in evaluation of ocular surface inflammation after pterygium resection combined with conjunctival autograft

作　　者：薛涛 郑雪丽 XUE Tao;ZHENG Xueli(Department of Ophthalmology,the First People’s Hospital of Xianyang City,Xianyang 712000,China)

机构地区：[1]咸阳市第一人民医院眼科,陕西咸阳712000 [2]咸阳市第一人民医院白内障中心,陕西咸阳712000

出　　处：《陕西医学杂志》2021年第6期709-712,共4页Shaanxi Medical Journal

基　　金：陕西省卫生健康委员会科研基金资助项目(2016E007)。

摘　　要：目的:应用颞侧球结膜眼红指数(TCHI)、眼部症状评分(OSS)及视觉模拟量表(VAS)研究翼状胬肉切除联合自体结膜移植术后患者眼表炎症反应变化情况,并将上述指标应用于抗炎治疗效果评价中,判断其应用有效性。方法:以100例翼状胬肉患者为研究对象,均采取翼状胬肉切除联合自体结膜移植术治疗,术后对眼表炎症进行治疗。评估术前,术后1、3、7、10 d,术后1、2个月眼表炎症,应用眼表综合分析仪对TCHI做出评估,观察OSS、VAS评分等主观量化指标的动态变化,采用荧光素钠染色法对角膜上皮愈合情况进行观察,并测量最佳矫正视力(BCVA)。结果:患者术后2个月BCVA明显较术前低(P<0.05)。术后10 d患者角膜无荧光素染色出现,提示角膜上皮缺损愈合完全。术后1 d OSS评分及TCHI值高于术前(均P<0.05);随着抗炎治疗的开展,患者术后7 d OSS评分及TCHI值均降至术前水平(均P>0.05);患者术后1、2个月上述指标均较术前低(均P<0.05)。患者术后1 d VAS评分高于术前(P<0.05);随着抗炎治疗的开展,患者术后7 d VAS评分降至术前水平(P>0.05);术后2个月VAS评分较术前低(P<0.05)。结论:OSS、VAS评分及TCHI可对行翼状胬肉切除联合自体结膜移植术治疗患者的炎症状态做出有效评估,并可作为抗炎治疗有效性的评价指标。Objective:To study the changes of ocular surface inflammation after pterygium excision combined with conjunctival autograft by TCHI,OSS and VAS,and to evaluate the efficacy of these indexes in anti-inflammatory treatment.Methods:100 patients with pterygium were taken as research objects.All patients were treated with pterygium resection combined with autologous conjunctival transplantation,and the ocular surface inflammation was treated after the operation.The ocular surface inflammation was evaluated before operation and 1 day,3 days,7 days,10 days,1 month and 2 months after operation.TCHI was evaluated by ocular surface analyzer.The dynamic changes of subjective quantitative indicators such as OSS and VAS were observed.The corneal epithelial healing was studied by fluorescein sodium staining,and BCVA was measured by fluorescein sodium staining.Results:BCVA at 2 months after operation was significantly lower than that before operation(P<0.05).There was no fluorescein staining in the cornea at 10th day after operation,which indicated that the corneal epithelial defect was completely healed.At 1st day after operation,the OSS score and TCHI were higher than those before operation(all P<0.05);with the development of anti-inflammatory treatment,the OSS score and TCHI at 7th day after operation decreased to the preoperative levels(all P>0.05);the above indexes at 1 and 2 months after operation were lower than those before operation(all P<0.05).At 1st day after operation,the VAS score was higher than that before operation(P<0.05);with the development of anti-inflammatory therapy,the VAS score of patients at 7th day after operation decreased to the preoperative level(P>0.05);the VAS score at 2 months after operation was lower than that before operation(P<0.05).Conclusion:OSS,VAS and TCHI can effectively evaluate the inflammatory status of patients undergoing pterygium resection and conjunctival autograft,and can be used as evaluation indicators for the effectiveness of anti-inflammatory treatment.

关 键 词：颞侧球结膜眼红指数 眼部症状评分 视觉模拟量表 翼状胬肉切除 自体结膜移植术 眼表炎症 

分 类 号：R779.6[医药卫生—眼科]