国产玻璃酸钠联合聚乙二醇滴眼液治疗斜视术后干眼症的效果观察

Effectiveness of Domestic Sodium Hyaluronate Combined with Polyethylene Glycol Eye Drops in the Treatment of Xerophthalmia after Strabismus Surgery

目的:探讨斜视术后干眼症患者应用国产玻璃酸钠联合聚乙二醇滴眼液的效果。方法:将2021年1月至2022年2月我院斜视术后干眼症患者89例(患眼89只)随机分为常规组(予以国产玻璃酸钠滴眼液治疗,n=44例44眼)和联合组(予以国产玻璃酸钠联合聚乙二醇滴眼液治疗,n=45例45眼),对比两组治疗1个月前后的干眼症状评分、泪膜功能参数变化、临床疗效、白细胞介素-8(Interleukin-8,IL-8)、白细胞介素-1β(Interleukin-1β,IL-1β)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)水平;生活质量采用干眼相关生活质量问卷(Dry Eye-Related Quality-of-Life Score,DEQS)进行评价。结果:治疗后,两组症状评分和角膜荧光染色(Fluorescein,FL)均明显降低,同时基础泪液分泌实验(Schirmer I test,SIt)和泪膜破裂时间(tear breakup time,BUT)升高,且联合组症状评分、FL、SIt和BUT治疗前后差值分别为(4.52±0.35)分、(2.60±0.93)分、(6.02±1.55)mm、(5.64±1.73)s,高于常规组的(2.20±0.35)分、(2.02±1.03)分、(4.81±1.36)mm、(3.82±1.60)s(P<0.05);联合组95.56%的临床总有效率和疗效相较于常规组的81.82%明显更优(P<0.05);两组治疗后IL-8、IL-1β以及TNF-α水平均降低,且联合组IL-8、IL-1β以及TNF-α水平治疗前后差值分别为(3.06±0.60)ng/L、(20.60±7.66)ng/L、(2.29±0.86)μg/L,均高于常规组的(2.11±0.65)ng/L、(11.06±8.31)ng/L、(1.38±0.93)μg/L(均P<0.05);联合组治疗2周及治疗1个月后的DEQS评分分别为(40.17±1.71)分、(32.44±1.16)分,均低于常规组的(44.38±1.89)分、(37.56±1.45)分(均P<0.05),两组治疗后DEQS评分均呈下降趋势,但联合组下降趋势较常规组明显(P<0.05)。结论:国产玻璃酸钠联合聚乙二醇滴眼液能够改善斜视术后干眼症症状和泪膜功能,疗效显著,且能够减轻术后炎性反应并提高生活质量。

Objective:To explore the effectiveness of the combination of two eye drops(domestic sodium hyaluronate plus polyethylene glycol)on xerophthalmia after strabismus surgery.Methods:89 patients with xerophthalmia after strabismus surgery(89 affected eyes)in the hospital were recruited between January 2021 and February 2022,and they were randomly assigned to regular group(receiving domestic sodium hyaluronate eye drops,n=44,44 eyes)and combined group(given eye drops of domestic sodium hyaluronate combined with polyethylene glycol,n=45,45 eyes).The xerophthalmia symptom score,tear film function parameters,clinical efficacy and changes in interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)were compared before and after 1 month of treatment.Dry Eye-related Quality-of-life Score(DEQS)was used for the evaluation of quality of life.Results:After treatment,symptom scores and corneal fluorescence staining(Fluorescein,FL)were significantly lower in both groups,while basal tear secretion test(Schirmer I test,SIt)and tear breakup time(BUT)were elevated,and the difference between symptom scores,FL,SIt and BUT before and after treatment in the combined group were(4.52±0.35),(2.60±0.93),(6.02±1.55)mm,(5.64±1.73)s,respectively,which were higher than those of the regular group(2.20±0.35),(2.02±1.03),(4.81±1.36)mm,(3.82±1.60)s(P<0.05);95.56%of the total clinical efficiency and efficacy of the combined group were higher than those of the regular group.The total clinical efficiency and efficacy of 95.56%in the combined group was significantly better than that of 81.82%in the regular group(P<0.05);the levels of IL-8,IL-1βand TNF-αdecreased in both groups after treatment,and the differences of IL-8,IL-1βand TNF-αlevels in the combined group before and after treatment were(3.06±0.60)ng/L,(20.60±7.66)ng/L and(2.29±0.86)μg/L,respectively.(7.66)ng/L,(2.29±0.86)μg/L,respectively,which were higher than(2.11±0.65)ng/L,(11.06±8.31)ng/L,(1.38±0.93)μg/L in the regular group(all P<0.05);the DEQS scores in the combined group after 2 weeks and 1 month of treatment were(40.17±1.71),(32.44±1.16)points,both lower than(44.38±1.89)and(37.56±1.45)points in the regular group(both P<0.05),and the DEQS scores in both groups showed a downward trend after treatment,but the downward trend in the combined group was more obvious than that in the regular group(P<0.05).Conclusion:Domestic sodium hyaluronate combined with polyethylene glycol eye drops can improve xerophthalmia symptom and tear film function after strabismus surgery,with significant efficacy,and can relieve postoperative inflammatory response and improve quality of life.