干眼超声雾化治疗联合维生素A棕榈酸酯眼用凝胶治疗白内障术后干眼的效果  

Efficacy of dry eye ultrasonic nebulization therapy combined with vitamin A palmitate ophthalmic gel on the treatment of dry eye after cataract surgery

作　　者：张秀杰 刘浩文 曹晶晶 Zhang Xiujie;Liu Haowen;Cao Jingjing(Department of Cataract,Zhoukou Eye Hospital(Zhoukou Seventh People′s Hospital),Zhoukou 461300,China;Department of Eyelid Diseases,Zhoukou Eye Hospital(Zhoukou Seventh People′s Hospital),Zhoukou 461300,China)

机构地区：[1]周口市眼科医院(周口市第七人民医院)白内障科,周口461300 [2]周口市眼科医院(周口市第七人民医院)眼睑疾病科,周口461300

出　　处：《中华眼外伤职业眼病杂志》2024年第12期924-930,共7页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察干眼超声雾化治疗联合维生素A棕榈酸酯眼用凝胶治疗白内障术后干眼的效果。方法前瞻性随机对照研究。纳入周口市眼科医院2023年5月至2024年5月白内障术后干眼80例(80眼),按照随机数字表法分为两组,对照组采用维生素A棕榈酸酯眼用凝胶滴眼治疗,观察组在对照组基础上行干眼超声雾化熏蒸治疗治疗,每组各40例。比较两组患者治疗前及治疗30 d后的眼部指标、眼表疾病指数(OSDI)评分、平均客观散射指数(OSI)、炎性因子和不良反应。结果治疗30 d后,观察组和对照组泪液分泌试验(SIt)分别为(9.96±2.05)和(8.68±1.67)mm/5 min、泪膜破裂时间(BUT)分别为(12.31±2.43)和(10.09±1.96)s,均高于治疗前的(3.19±0.52)和(3.25±0.48)mm/5 min、(12.31±2.43)和(10.09±1.96)s(t=34.90、35.10、30.37、24.20,均P<0.001);角膜荧光染色(FL)分别为(0.95±0.28)和(1.35±0.36)分,OSDI评分分别为(19.27±3.24)和(24.22±4.36)分,OSI分别为(1.08±0.21)和(1.51±0.27)mm,白细胞介素-6(IL-6)分别为(1.04±0.20)和(1.21±0.26)ng/mL,白细胞介素-1β(IL-1β)分别为(35.28±6.73)和(50.65±8.46)ng/mL,基质金属蛋白酶-9(MMP-9)分别为(25.31±4.07)和(33.52±6.31)ng/mL,均低于治疗前[(1.95±0.43)和(2.07±0.50)分、(31.35±6.72)和(30.73±7.08)分、(2.33±0.46)和(2.35±0.43)mm、(1.49±0.31)和(1.54±0.33)ng/mL、(99.53±12.14)和(98.14±12.56)ng/mL、(57.23±11.04)和(56.46±10.37)ng/mL(t=29.03、18.02、21.47、11.42、15.63、24.31、18.11、15.82、64.81、47.28、32.72、33.88,均P<0.001)];治疗30 d后观察组SIt、BUTs高于对照组(t=3.06、4.50,P=0.003、P<0.001);FL、OSDI评分、OSI、IL-6、IL-1β、MMP-9显著低于对照组(t=5.55、5.76、7.95、3.28、8.99、6.92,P<0.001、<0.001、<0.001、P=0.002、<0.001、<0.001);两组患者用药过程中,均未出现任何不良反应。结论干眼超声雾化治疗仪熏蒸联合维生素A棕榈酸酯眼用凝胶治疗白内障术后干眼效果明显,可帮助患者分泌泪液,改Objective To observe the effect of dry eye ultrasonic nebulization therapy combined with vitamin A palmitate ophthalmic gel in the treatment of dry eye after cataract surgery.Methods This was a prospective randomised controlled study.Eighty eyes of 80 cases of dry eye after cataract surgery were selected from May 2023 to May 2024 in Zhoukou Eye Hospital,and all cases were divided into two groups based on randomised numerical table methods.The control group was treated with vitamin A palmitate ophthalmic gel drops,and the observation group was treated with dry eye ultrasonic nebulization fumigation therapy on the basis of the control group,with 40 cases in each group.The ocular indexes,ocular surface disease index(OSDI)scores,mean objective scattering index(OSI),inflammatory factors,and adverse reactions of the two groups were compared before and after 30 d of treatment.Results After 30 d of treatment,Schirmer I test(SIt)was(9.96±2.05)and(8.68±1.67)mm/5min and break-up time(BUT)was(12.31±2.43)and(10.09±1.96)s in the observation and control groups,which were higher than the(3.19±0.52)and(3.25±0.48)mm/5 min,and the(12.31±2.43)and(10.09±1.96)s before treatment(t=34.90,35.10,30.37,24.20;all P<0.001);Coreal fluorescein staining(FL)was(0.95±0.28)and(1.35±0.36)points,and OSDI scores were(19.27±3.24)and(24.22±4.36)points,and OSI was(1.08±0.21)and(1.51±0.27)mm,and interleukin-6(IL-6)was(1.04±0.20)and(1.21±0.26)ng/mL,and interleukin-1β(IL-1β)was(35.28±6.73)and(50.65±8.46)ng/mL,and matrix metalloproteinase-9(MMP-9)was(25.31±4.07)and(33.52±6.31)ng/mL,respectively,which were lower than those before treatment[(1.95±0.43)and(2.07±0.50)points,(31.35±6.72)and(30.73±7.08)points,(2.33±0.46)and(2.35±0.43)mm,(1.49±0.31)and(1.54±0.33)ng/mL,(99.53±12.14)and(98.14±12.56)ng/mL,and(57.23±11.04)and(56.46±10.37)ng/mL(t=29.03,18.02,21.47,11.42,15.63,24.31,18.11,15.82,64.81,47.28,32.72,33.88;all P<0.001)];After 30 d of treatment,SIt and BUTs of the observation group were higher than those of the control group(

关 键 词：维生素A 白内障 干眼 

分 类 号：R47[医药卫生—护理学]