优化脉冲光辅助治疗蠕形螨相关鳞屑性睑缘炎的疗效及对眼表状态的影响  

Optimization of the effect of pulsed light in the treatment of Demodex-associated squamous blepharitis and its effect on ocular surface function and corneal cell density

作　　者：安琳[1] 韦秋红 曾悦[1] 高伟娜[1] 陈琛[1] 张荣 AN Lin;WEI Qiuhong;ZENG Yue;GAO Weina;CHEN Chen;ZHANG Rong(Department of Ophthalmology,Baoding NO.1 Central Hospital,Baoding 071000,Hebei,China)

机构地区：[1]保定市第一中心医院眼科,河北保定071000

出　　处：《山东大学耳鼻喉眼学报》2023年第3期77-82,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：保定市科技计划项目(2141ZF086)。

摘　　要：目的探究优化脉冲光辅助治疗蠕形螨相关鳞屑性睑缘炎的疗效及对眼表状态的影响。方法选取60例(120眼)蠕形螨相关鳞屑性睑缘炎患者作为研究对象,按照随机数字表法按1∶1比例分为观察组、对照组,各30例(60眼)。对照组采用妥布霉素地塞米松眼膏、茶树油眼睑湿巾治疗,观察组在对照组基础上加用优化脉冲光辅助治疗。比较两组疗效、治疗前后症状评分、体征评分、蠕形螨计数、眼表功能[泪膜破裂时间(tear film rupture time,TBUT)、结膜充血程度、角膜荧光染色(fluorescence staining,FL)、泪河高度(tear river height,TMH)]及安全性。结果观察组总有效率91.67%较对照组78.33%高(P=0.041);治疗后观察组症状评分、体征评分、蠕形螨计数较对照组低(P均<0.001);治疗后观察组TBUT较对照组高,结膜充血程度、FL、TMH较对照组低(P=0.012,P<0.001,P<0.001,P<0.001);两组患者均未发生明显并发症。结论优化脉冲光辅助治疗蠕形螨相关鳞屑性睑缘炎效果显著,可有效促使症状改善、降低蠕形螨数量、提高眼表功能、缓解角膜损伤、安全性高。Objective To explore the efficacy of adjuvant therapy with optimized pulsed light for Demodex-associated scaly blepharitis and its effect on ocular surface status.Methods A cohort of 60 cases(120 eyes)of Demodex-related squamous blepharitis were selected as the research objects.Patients/eyes were divided into the observation and control groups according to the random number table method in a ratio of 1∶1,with 30 cases(60 eyes)in each group.The control group was treated with tobramycin dexamethasone ointment and tea tree oil ointment,and the observation group was treated with optimized pulsed light adjuvant therapy on the basis of the control group.We subsequently compared the treatment efficacy,symptom scores before and after treatment,sign scores,demodex count,ocular surface function[tear film rupture time(TBUT),conjunctival hyperemia,corneal fluorescence staining(FL),tear river height(TMH)],and safety between the two groups.Results The total effective rate of the observation group(91.67%)was higher than that of the control group(78.33%)(P=0.041);the observation group's symptom score,physical sign score,and demodex count after treatment were lower than those of the control group(all P<0.001);the observation group had a lower TBUT than the control group after treatment high,conjunctival hyperemia,FL,TMH lower than the control group(P=0.012,P<0.001,P<0.001,P<0.001).There was no significant difference in the occurrence of complications between the two groups.Conclusion Optimized pulsed light assisted treatment is an effective treatment modality for Demodex-related squamous blepharitis,which can effectively promote the improvement of symptoms,reduce the number of Demodex,improve ocular surface function,and relieve corneal damage with high safety.

关 键 词：优化脉冲光 蠕形螨 鳞屑性睑缘炎 眼表功能 角膜细胞密度 

分 类 号：R777[医药卫生—眼科]