术前睑板腺按摩应用于白内障合并睑板腺功能障碍术后干眼症患者的效果观察

Observation of the effect of preoperative meibomian gland massage on dry eye patients with cataract complicated with meibomian gland dysfunction

目的:分析白内障合并睑板腺功能障碍患者术前行睑板腺按摩的效果及对其眼表指标、睑板腺功能的影响。方法:选择2021年6月-2023年6月收治的合并睑板腺功能障碍的白内障手术患者97例,采用掷币法分为对照组48例和观察组49例。对照组行围术期常规护理,观察组在对照组基础上术前2周加睑板腺按摩。术后1个月比较两组患者的感觉性症状评分、眼表指标、睑板腺功能和不良事件情况。结果:与术前2周比较,观察组术前1天泪膜破裂时间(BUT)、泪液分泌试验(SIT)延长,眼表疾病指数(OSDI)评分下降(P<0.05);与术前1天比较,术后1周、术后1个月两组BUT和SIT缩短,OSDI评分增高(P<0.05);观察组术后1周、术后1个月BUT和SIT较对照组长;术后1周OSDI评分较对照组低(P<0.05)。术后1个月,观察组睑板开口评分低于对照组,泪河高度高于对照组(P<0.05)。术后1个月和3个月,观察组感觉性症状评分低于对照组,差异有统计学意义(P<0.05)。两组不良事件发生率比较,差异无统计学意义(P>0.05)。结论:白内障合并睑板腺功能障碍患者术前行睑板腺按摩,可迅速、安全地缓解患者感觉性症状,并有效改善睑板腺功能和眼表指标。

Objective:To analyze the effect of preoperative meibomian gland massage on ocular surface indexes and meibomian gland function in patients with cataract complicated with meibomian gland dysfunction.Methods:All 97 cataract surgery patients with meibomian gland dysfunction in department from June 2021 to June 2023 were divided into control group and observation group by toss method.The control group received routine perioperative care,on the basis of the control group observation group plus meibomian gland massage before one week.The sensory symptom score,ocular surface index,meibomian gland function and adverse events were compared between the two groups 1 month after operation.Results:Compared with 2 weeks before operation,the tear film break-up time(BUT),tear secretion test(SIT)and ocular surface disease index(OSDI)were prolonged 1 day before operation in the observation group.Compared with 1 day before operation,BUT and SIT were shortened and OSDI score was increased at 1 week and 1 month after operation.But and SIT were longer in the observation group than in the control group at 1 week and 1 month after operation,and the score of OSDI was lower in the observation group than in the control group at 1 week after operation.One month after operation,the score of tarsal opening in the observation group was lower than that in the control group,and the height of lacrimal river in the observation group was higher than that in the control group.The scores of sensory symptoms in the observation group were lower than those in the control group at 1 and 3 months after operation(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion:Preoperative meibomian gland massage can quickly and safely relieve sensory symptoms of patients with cataract complicated with meibomian gland dysfunction,and effectively improve meibomian gland function and ocular surface indexes.