泪道探通联合妥布霉素地塞米松填充治疗泪道阻塞
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摘要
目的:探讨泪道探通术联合妥布霉素地塞米松眼膏填充治疗对泪道阻塞患者眼表症状和生活质量的影响。方法:选取2016-10/2018-01我院收治的泪道阻塞患者120例120眼,按照治疗方法分为对照组(n=60)和观察组(n=60)。对照组予以单纯泪道探通术治疗,观察组予以泪道探通术联合妥布霉素地塞米松眼膏填充治疗。比较两组患者临床疗效、治疗前后眼表疾病指数量表(OSDI)评分及血清超敏C反应蛋白(hs-CRP)、降钙素原(PCT)水平的变化。结果:观察组临床疗效明显优于对照组(P<0.05)。治疗后1mo,观察组OSDI总分及眼部不适频率评分、眼部不适对日常生活的影响评分、不良环境眼部不适发生频率评分均较术前明显降低(P<0.05)。治疗后1mo,观察组血清hs-CRP、PCT水平均明显低于对照组(P<0.05)。结论:泪道探通术联合妥布霉素地塞米松眼膏填充治疗泪道阻塞疗效显著,能够有效改善患者眼表症状和生活质量。
·AIM: To explore the effect of lacrimal duct probing combined with tobramycin and dexamethasone ophthalmic ointment on ocular surface symptoms and quality of life of patients with lacrimal duct obstruction.·METHODS: A total of 120 patients(120 eyes) with lacrimal duct obstruction treated in the hospital from October 2016 to January 2018 were selected. They were randomly divided into control group(n=60) and observation group(n=60) according to the treatment methods. The control group was treated with simple lacrimal duct probing while the observation group was treated with lacrimal duct probing combined with illing with tobramycin and dexamethasone. The clinical efficacy, changes in ocular surface disease index(OSDI) score, levels of serum high-sensitivity C-reactive protein(hs-CRP) and procalcitonin(PCT) before and after treatment were compared between the two groups.·RESULTS: The clinical efficacy in observation group was significantly better than that in control group(P<0.05). The total score of OSDI, scores of the frequency of eye discomfort, the effect of eye discomfort on daily life and the frequency of eye discomfort caused by adverse environment in the observation group were significantly decreased after treatment(P<0.05). The levels of serum hs-CRP and PCT in the observation group were significantly lower than those in the control group after treatment(P<0.05).·CONCLUSION: Lacrimal duct probing combined with tobramycin and dexamethasone is markedly effective in the treatment of lacrimal duct obstruction. It can effectively relieve the ocular surface symptoms and improve quality of life of patients.
·AIM: To explore the effect of lacrimal duct probing combined with tobramycin and dexamethasone ophthalmic ointment on ocular surface symptoms and quality of life of patients with lacrimal duct obstruction.·METHODS: A total of 120 patients(120 eyes) with lacrimal duct obstruction treated in the hospital from October 2016 to January 2018 were selected. They were randomly divided into control group(n=60) and observation group(n=60) according to the treatment methods. The control group was treated with simple lacrimal duct probing while the observation group was treated with lacrimal duct probing combined with illing with tobramycin and dexamethasone. The clinical efficacy, changes in ocular surface disease index(OSDI) score, levels of serum high-sensitivity C-reactive protein(hs-CRP) and procalcitonin(PCT) before and after treatment were compared between the two groups.·RESULTS: The clinical efficacy in observation group was significantly better than that in control group(P<0.05). The total score of OSDI, scores of the frequency of eye discomfort, the effect of eye discomfort on daily life and the frequency of eye discomfort caused by adverse environment in the observation group were significantly decreased after treatment(P<0.05). The levels of serum hs-CRP and PCT in the observation group were significantly lower than those in the control group after treatment(P<0.05).·CONCLUSION: Lacrimal duct probing combined with tobramycin and dexamethasone is markedly effective in the treatment of lacrimal duct obstruction. It can effectively relieve the ocular surface symptoms and improve quality of life of patients.
引文
1姜茂华. 泪道引流管联合盐酸洛美沙星凝胶泪道内注射治疗泪道阻塞的疗效观察. 重庆医学 2016;45(22):3129-3130
2李玉茹,程相辅,刘晓瑞. 泪道激光联合引流管和支架治疗复杂性泪道阻塞的疗效. 国际眼科杂志 2016;16(7):1378-1379
3胥利平,周明,刘豪杰,等. 泪道置管术治疗泪道阻塞或狭窄的临床疗效及并发症处理. 临床眼科杂志 2016;24(1):67-69
4王静,赵江月,陆璐,等. 妥布霉素地塞米松滴眼液对白内障术后眼部炎症反应有效性和安全性的临床观察. 眼科 2015;24(1):51-55
5陆纯,袁文奕,赵玉瑾,等. 鼻泪道阻塞患者逆行置管手术前后眼表疾病指数变化的临床研究. 中国眼耳鼻喉科杂志 2017;17(4):261-264
6胡曼,吴倩,樊云葳,等. 泪道插管术与球囊管扩张术治疗探通无效的先天性鼻泪道阻塞患者的比较研究. 中华眼科杂志 2016;52(2):123-128
7 Al-Faky YH, Mousa A, Kalantan H,et al. A prospective, randomised comparison of probing versus bicanalicular silastic intubation for congenital nasolacrimal duct obstruction. Br J Ophthalmol 2015;99(2):246-250
8王华. 改良的泪道引流管置管术治疗泪道阻塞性疾病的临床效果. 江苏医药 2016;42(13):1504-1505
9赵晔,刘志锋. 不同进针方式联合不同泪道冲洗液泪道探通术治疗婴幼儿泪囊炎临床观察. 海南医学 2016;27(20):3358-3360
10杨卓,秦华丽,任珊. 两种泪道探通术治疗不同年龄婴幼儿泪囊炎疗效探讨. 中国斜视与小儿眼科杂志 2014;22(4):19-21
11 Jr GJ, Tollesonrinehart S, Huynh K,et al. A review of quality of life measures in dry eye questionnaires. Cornea 2014;33(2):215-218
12林晨,杨敏敏,郑虔. 眼表疾病指数量表中文版的研制和性能评价. 眼科新进展 2013;33(1):38-40
13张佳楠,李海丽,晏晓明. 两种干眼症状问卷评分与干眼临床检查的关联性研究. 中华实验眼科杂志 2012;30(4):362-366
14孙红梅,韩毳,陶海,等. 95例泪道阻塞患者阻塞部位分布及相关因素的初步分析. 中国中医眼科杂志 2013;23(2):127-130
15杨晓钊,杨华,张懿,等. 盐酸赛洛唑啉喷鼻联合泪道激光置管术治疗鼻泪管阻塞. 国际眼科杂志 2017;17(2):357-358
16王彦方. 内窥镜下泪道再通联合中药治疗泪道阻塞性疾病的临床观察. 中华中医药学刊 2015;33(2):478-480
17程相辅,赵越娟. 盐酸洛美沙星眼用凝胶治疗泪道阻塞的疗效. 国际眼科杂志 2017; 17(9):1793-1795
2李玉茹,程相辅,刘晓瑞. 泪道激光联合引流管和支架治疗复杂性泪道阻塞的疗效. 国际眼科杂志 2016;16(7):1378-1379
3胥利平,周明,刘豪杰,等. 泪道置管术治疗泪道阻塞或狭窄的临床疗效及并发症处理. 临床眼科杂志 2016;24(1):67-69
4王静,赵江月,陆璐,等. 妥布霉素地塞米松滴眼液对白内障术后眼部炎症反应有效性和安全性的临床观察. 眼科 2015;24(1):51-55
5陆纯,袁文奕,赵玉瑾,等. 鼻泪道阻塞患者逆行置管手术前后眼表疾病指数变化的临床研究. 中国眼耳鼻喉科杂志 2017;17(4):261-264
6胡曼,吴倩,樊云葳,等. 泪道插管术与球囊管扩张术治疗探通无效的先天性鼻泪道阻塞患者的比较研究. 中华眼科杂志 2016;52(2):123-128
7 Al-Faky YH, Mousa A, Kalantan H,et al. A prospective, randomised comparison of probing versus bicanalicular silastic intubation for congenital nasolacrimal duct obstruction. Br J Ophthalmol 2015;99(2):246-250
8王华. 改良的泪道引流管置管术治疗泪道阻塞性疾病的临床效果. 江苏医药 2016;42(13):1504-1505
9赵晔,刘志锋. 不同进针方式联合不同泪道冲洗液泪道探通术治疗婴幼儿泪囊炎临床观察. 海南医学 2016;27(20):3358-3360
10杨卓,秦华丽,任珊. 两种泪道探通术治疗不同年龄婴幼儿泪囊炎疗效探讨. 中国斜视与小儿眼科杂志 2014;22(4):19-21
11 Jr GJ, Tollesonrinehart S, Huynh K,et al. A review of quality of life measures in dry eye questionnaires. Cornea 2014;33(2):215-218
12林晨,杨敏敏,郑虔. 眼表疾病指数量表中文版的研制和性能评价. 眼科新进展 2013;33(1):38-40
13张佳楠,李海丽,晏晓明. 两种干眼症状问卷评分与干眼临床检查的关联性研究. 中华实验眼科杂志 2012;30(4):362-366
14孙红梅,韩毳,陶海,等. 95例泪道阻塞患者阻塞部位分布及相关因素的初步分析. 中国中医眼科杂志 2013;23(2):127-130
15杨晓钊,杨华,张懿,等. 盐酸赛洛唑啉喷鼻联合泪道激光置管术治疗鼻泪管阻塞. 国际眼科杂志 2017;17(2):357-358
16王彦方. 内窥镜下泪道再通联合中药治疗泪道阻塞性疾病的临床观察. 中华中医药学刊 2015;33(2):478-480
17程相辅,赵越娟. 盐酸洛美沙星眼用凝胶治疗泪道阻塞的疗效. 国际眼科杂志 2017; 17(9):1793-1795