中老年睑板腺功能障碍的临床分析

Clinical analysis of meibomian gland dysfunction in elderly patients

目的:探讨中老年患者睑板腺功能障碍(MGD)的临床特点及诊治要点。方法:通过问卷调查、泪膜破裂时间、ShimmerⅠ试验、角膜荧光素染色及睑板腺分泌物的检查,将74例145眼睑板腺功能障碍患者分为轻度、中度、重度三组,根据疾病程度,分别行睑缘清洁、疏通、按摩、人工泪液、或抗炎、抗感染等联合治疗。结果:睑板腺功能障碍患者74例145眼治疗1mo后,眼表疾病指数评分下降,睑腺分泌物评分下降,泪膜破裂时间延长,眼表活体染色评分下降。各型MGD的总治愈率34.5%,总有效率98.6%。结论:眼科医师应掌握中老年睑板腺功能障碍的临床特点,重视症状、病史的询问及眼表及睑板腺功能的检查。避免睑板腺功能障碍的误诊、误治。

AIM： To explore the clinical features, diagnosis and treatment of meibomian gland dysfunction （MGD） in elder patients. METHODS. Through the questionnaire survey, tear break-up time, Shimmer I test, corneal fluorescein staining and meibomian gland secretion examination, 74 cases （145 eyes） of meibomian gland dysfunction were divided into mild, moderate, severe group. According to the disease degree, dredging, cleaning combined eyelid massage, artificial tears, or anti- inflammatory, anti- infection were performed, respectively. RESULTS, Totally 74 patients were treated for meibomian gland dysfunction （MGD） with 145 eyes. After one month, the ocular surface disease index decreased, the meibomian gland secretion grade lowered, the time period of tear broken was extended, the ocular surface staining grade lowered. The ratio of total cure was 34.5%, and the ratio of efficiency was 98.6%. CONCLUSION. Ophthalmology physicians should master the clinical characteristic of MGD for the elderly patients. Symptoms, illness history inquiry and MGD test were highly regarded to avoid misdiagnosis and error treatment.