人工泪液联合泪点栓塞术治疗眼干燥症的效果观察

目的研究单纯人工泪液玻璃酸钠、单纯行泪点栓塞术或其两者联合治疗中重度眼干燥症（干眼病）的临床疗效。方法选取中重度眼干燥症73例（135眼），随机分为人工泪液组25例（46眼）、手术组24例（44眼）和联合组24例（45眼）。人工泪液组仅用0．1％玻璃酸钠滴眼液每日滴眼4次；手术组对中度眼干燥症行下泪点栓塞术，重度眼干燥症行上、下泪点栓塞术；联合组在行泪点栓塞术基础上，再每日给予0．1％玻璃酸钠滴眼液滴眼4次。3组均连续治疗2周后评价疗效，比较3组治疗前后及治疗后各组之间的临床症状和检查泪液基础分泌试验（SIt）、泪膜破裂时间（BUT）及荧光素染色试验结果。结果手术组和联合组的主观症状、Sit、BUT和荧光素染色的改善程度明显优于泪液组（P〈0．05，P〈0．01）；而联合组的主观症状、BUT的改善程度明显优于手术组（P〈0．05）。结论中重度眼干燥症进行人工泪液滴眼联合泪点栓塞术治疗在3种方法中效果最好。

Observation on therapeutic efficacy of artificial dacryma combined with lacrimal punctum embolization in the treatment of ophthalmoxerosis

Objective To evaluate the clinical therapeutic efficacy of artificial dacryma containing sodium sulfacetamide,lacrimal punctum embolization and their therapeutic effect in the treatment of mide and severe ophthalmoxerosis respectively.Methods 73 cases(135 eyes)with mide and severe ophthalmoxerosis were randomly divided into dacryma therapy group including 25 cases(46 eyes),operation therapy group including 24 cases(44 eyes)and therapeutic alliance group including 24 cases(45 eyes)respectively.The cases in dacryma therapy group were treated qid with 0.1% sodium hyaluronate.In the cases of operation therapy group,the cases with mide ophthalmoxerosis were operated with infra-lacrimal puncta embolization and the cases with severe ophthalmoxerosis were operated with infra-and upper-lacrimal puncta embolization.The cases in therapeutic alliance group were treated with lacrimal puncta embolization and qid of 0.1% sodium hyaluronate.After being treated two weeks,all cases were investigated and analyzed by the clinical symptom,Schirmer test(SIt),Break-up time(BUT)test and fluorescein staining assay.Results The clinical symptom,SIt,BUT and fluorescein staining were improved by three therapeutic methods,but the improve level of operation therapy group and therapeutic alliance group were significantly higher than that in dacryma therapy group(P<0.05,<0.01).The improved level of clinical symptom and BUT of cases in therapeutic alliance group were significantly higher than that in operation therapy group(P<0.05).Conclusion WTBZ]The treatment method of lacrimal punctum embolization combined with artificial dacryma is the best method in three methods for mide and severe ophthalmoxerosis.