甲状腺相关眼病致眼睑闭合不全的两种护理方法比较

目的 评价不同方法用于甲状腺相关眼病引起的眼睑闭合不全的效果,以预防因眼睑闭合不全引起的结膜充血、干燥、流泪、暴露性角膜病变等.方法 将160例甲状腺相关眼病引起的眼睑闭合不全患者随机分两组,对照组采用传统方法妥布霉素滴眼液点患眼加红霉素眼膏涂抹患眼,实验组在对照组的基础上联合3M透明敷料黏贴法保护患眼.观察并比较两组患者角膜上皮缺损改善情况和眼部并发症发生情况.结果 72 h后实验组角膜上皮缺损的总改善率为95.8％,对照组为61.0％,两组比较差别有统计学意义（P＜0.05）.实验组治疗后眼部不适症状共发生34只眼,发生率23.6％,对照组发生104只,发生率70.3％,两组发生率比较,差别有统计学意义（P＜0.01）.结论 采用妥布霉素滴眼液冲洗加红霉素眼膏涂抹,联合3M透明敷料黏贴法保护患眼,可有效减轻眼部不适,降低并发症发生率,是一种较为理想且操作简便的眼部护理方法.

Comparison of two different nursing methods for lagophthalmus induced by thyroid-associated ophthalmopathy

Objective To evaluate the effectiveness of two methods for lagophthalmus induced by thyroid-associated ophthal- mopathy, so as to prevent some complications of ocular surface such as conjunctival hyperemia, dry eye, tears, exposure keratopathy. Methods 160 patients diagnosed as having thyroid-associated ophthalmopathy with lagophthalmus were randomly divided into two groups. In the study group, the affected eyes were protected by transparent medical film（ 3M Tegaderm）, as well as treated by tobramycin eye drops and erythromycin eye ointment. In the control group, the affected eyes were just protected by tobramycin eye drops and erythromycin eye ointment in the same duration. The improvement of the corneal epithelium defect and other complications of ocular surface in the two groups were observed and compared. Results After 72 hours, the conditions of the corneal epithelium defect improved in 95.8% of eyes in the study group as well as in 61.0% of eyes in the control group, The results had statistically significant difference between the two groups（P 〈0.05）. Eye symptoms of discomfort occurred in 34 eyes （23.6%） in the study group as well as in 104 eyes （70.3%） in the control group. The results had statistically significant difference between the two groups （P 〈0.01 ）. Conclusions The appropriate application of transparent medical film combined with antibiotic eye drops and eye ointment can relieve the patient＇ s eye symptoms of discomfort and reduce the incidence of complications. It is an ideal and easy way to treat this aliment.