Smart Plug泪小管栓塞治疗重度综合征观察Sjogren

Clinical observation of smart plug punctum occlusion in the treatment of severe Sjogren syndrome

目的探讨SmartPlug泪小管栓子在治疗重度Sjogren综合征（Sjogren Syndrome，SS）中的临床疗效。方法临床病例自身对照研究。对2007年11月至2011年2月在鄂州市中心医院眼科就诊的重度sS的患者36例（72只眼）单眼并在上下泪点植入Smart Plug泪点栓子；另一眼作为对照眼。观察治疗后的症状及体征改变。结果两例因溢泪症状被排除，除Schirmer试验外，泪小管栓塞组较对照组均有明显改善，两组间比较差异有统计学意义（P〈0．01）。泪小管栓塞组无一例泪点栓子丢失。结论Smart Plug泪小管栓子能够简单、有效地改善重度SS的干眼症状及结膜鳞状化生程度。泪小管栓塞是一种安全地、无创的非药物治疗方法，在治疗重度干眼症患者中值得推广。

Objective To evaluate the clinical efficacy of Smart Plug lacrimal puncture occlu- sion in the treatment of severe dry eye caused by Sj^gren syndrome （SS）. Methods Thirty-six pa- tients of severe Sjogren syndrome were selected. Uniocular punctum occlusion by Smart Plug punc- tum plug in the upper and lower puncta, and the other eye, in the same patient, was not occluded and served as control eye. The eye be occluded was randomly selected. Both eye were continue used their dry eye medications. Both eye were evaluated by Schirmer test, rose Bengal test, tear break-up time （TBUT）, and OSDI questionnaire survey. Impression cytology combination with PAS staining was performed to observe conjunctive squamous metaplasia before and two months after pun- cum occlusion. Results Two patients dropped out. In the occluded eye, a significant improvement in TBUT, OSDI score, rose Bengal test and PAS staining were found but Schirmer test. There was a significant difference in test group and control group. Conclusions Smart Plug punctum plug im- prove the subjective discomfort and conjunctive squamous metaplasia of severe Sjogren syndrome. It is a safe and non-invasive method, and be worth promoting in the treatment of severe dry eye caused by Sjogren syndrome.