眼睑闭合不全患者术前应用带中央视窗的新型眼部敷料改善眼表的效果观察  

Efficacy of preoperatively applying novel eye dressing with central window in alleviating ocular surface symptoms among thyroid associated ophthalmopathy patients with lagophthalmos

作　　者：沙颖[1] 张瑞恒 黄昆 Sha Ying;Zhang Ruiheng;Huang Kun(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University、Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院、北京同仁眼科中心眼科学与视觉科学北京市重点实验室,100730

出　　处：《眼科》2023年第1期45-48,共4页Ophthalmology in China

基　　金：北京市医院管理局“登峰”人才培养计划(DFL20150201)。

摘　　要：目的观察带中央视窗的新型眼部敷料在甲状腺相关眼病眼睑闭合不全患者应用改善眼表的效果。设计前瞻性随机对照试验。研究对象北京同仁医院40例甲状腺相关眼病行眼眶减压手术的住院患者。方法随机数字表法分为原有治疗模式组(对照组)20例,及晚间睡眠时加盖带中央视窗的新型眼部敷料组(观察组)20例。3日后评估主、客观症状改善情况及进行Kolcaba舒适度量表评分和疼痛评分。主要指标角膜荧光素染色、泪膜破裂时间、Schirmer Ⅱ泪液分泌实验结果、Kolcaba舒适度量表评分和疼痛评分。结果3日后对照组及观察组的泪膜破裂时间(5.90±2.27秒、8.93±5.22秒,P=0.02)、Schirmer Ⅱ泪液分泌实验[5.0 mm(2.0~10.0 mm)、9.0 mm(6.0~15.0 mm),P=0.02]、Kolcaba眼部舒适度评分(72.10±4.72分、77.36±4.98分,P=0.015)均存在显著差异。对照组及观察组角膜点状缺损数量[4个(2~5个)、1个(0~2个),P=0.001]、疼痛评分[1分(0~1分)、0分(0~0分),P=0.01]也存在显著差异。结论短期使用带有中央视窗的新型眼部敷料可提升甲状腺相关眼病眼睑闭合不全患者的泪膜稳定性,有利于角膜上皮损伤修复,并提高眼表舒适度。Objective To observe the effect of a novel type eye dressing with central window in alleviating ocular surface symptoms among thyroid associated ophthalmopathy patients with lagophthalmos.Design prospective randomized controlled trial.Participants 40 patients with thyroid-associated ophthalmopathy underwent orbital decompression surgery in Beijing Tongren Hospital.Method Forty patients were randomly divided into groups by the numerical table method,20 of whom used the new eye dressing with central window(observation group),and the other 20 were in the control group.The observation group received the novel eye dressing with central window during night sleeping,while the control group was treated with the original mode for three consecutive days.The patient's subjective and objective symptom improvement was evaluated.The Kolcaba comfort scale and pain score were questionnaired.Main Outcome Measures corneal fluorescein staining,tear film rupture time,Schirmer Ⅱ test,the Kolcaba comfort scale and pain rating scale.Results After 3 consecutive days,the tear film rupture time in the observation group was significantly prolonged(5.90±2.27 s vs.8.93±5.22 s,P=0.02),the Schirmer Ⅱ tear test was increased[5.0mm(2.0-10.0 mm)vs 9.0 mm(6.0-15.0 mm,P=0.02)],and the ocular comfort score was significantly improved(72.10±4.72 vs.77.36±4.98,P=0.015).The number of punctate epithelial erosions[4(2-5)vs.1(0-2)points,P=0.001]and pain scores[1(0-1)vs.0(0-0),P=0.01]in the observation group were significantly reduced after using the novel eye dressing compared with control group.Conclusions Short-term use of the novel type eye dressing with central window improved tear film stability,promoted recovery of corneal epithelial damage,and improved ocular comfort in patients with thyroid-related ophthalmopathy patients with lagophthalmos.

关 键 词：眼睑闭合不全 新型眼部敷料 舒适度 泪膜稳定性 

分 类 号：R779.6[医药卫生—眼科]