还原型谷胱甘肽滴眼液促进翼状胬肉术后角膜上皮修复

Clinical study of glutathione ophthalmic solution for healing the corneal epithelium after excision for pterygium

目的观察翼状胬肉单纯切除联合巩膜暴露术后应用还原型谷胱甘肽滴眼液的临床反应以及角膜上皮缺损区的愈合过程,评价该药物对角膜上皮修复的促进作用。方法对60例(60眼)翼状胬肉患者进行胬肉单纯切除联合巩膜暴露术,术后在给予每位患者完全相同的抗菌、抗炎治疗的基础上随机将其分为两组:实验组30例(眼),加用还原型谷胱甘肽滴眼液滴眼2周;对照组30例(眼),不加还原型谷胱甘肽滴眼液,即空白对照组。实验组和对照组在年龄、性别、胬肉大小方面差异无统计学意义(P>0.05)。随访期间观察术后的症状指标,如疼痛、畏光、流泪、异物感、混合性充血并予评分,同时记录角膜上皮的愈合情况及速度。结果实验组术后的症状指标总体评分在术后第3、第5、第7天与对照组比较,差异有统计学意义(P<0.05)(其分值分别为7.19±2.16/8.23±3.54、4.87±2.55/6.26±2.39和3.15±2.28/5.03±2.57)。角膜上皮修复的客观体征:实验组患者角膜上皮的完全修复时间为(4.53±1.32)d,对照组为(6.01±2.27)d,差异有统计学意义(P<0.05)。结论翼状胬肉单纯切除联合巩膜暴露术后使用还原型谷胱甘肽滴眼液,能够减轻术后早期疼痛、畏光、流泪、充血、异物感等眼表刺激症状,并有效缩短角膜上皮缺损的愈合时间,有助于术后角膜上皮机械性损伤的修复。

Objective To evaluate the effect of glutathione ophthalmic solution on corneal epithelium recovery after pterygium excision—＂bare sclera＂ procedure.Methods An excision—＂bare sclera＂ procedure—was performed on sixty patients with pterygium.A randomized study enrolled 30 patients（treatment group） who were treated with glutathione＋antibiotics＋steroid eyedrops and 30 patients（control group） who were treated with antibiotics ＋steroid eyedrops after the operation.Pain,photophobia,foreign body sensation,tearing,congestion and healing time of epithelial tissue were observed and rated according to accepted standards at 1 day,3 days,5 days,7 days and 14 days postoperatively.Results There were no differences in age,sex or size of the pterygium between the treatment and control groups.There were differences in pain,photophobia,foreign body sensation,tearing,and congestion at 3 days,5 days,and 7 days（P〈0.05）,but there was no difference between the two groups at 1 day and 14 days（P〉0.05）.The heal-ing time of the epithelium for the treatment group was（4.53±1.32） days and was（6.01±2.27）days for the control group.There was a significant difference in healing time between the two groups（P〈 0.05）.Conclusion Glutathione ophthalmic solution may relieve early pain,foreign body sensation,photophobia,tearing and congestion after pterygium excision—＂bare sclera＂ procedure—and clearly shortens healing time.Glutathione is beneficial for epithelium recovery from mechanical injury.