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高原官兵眼干燥症治疗方案探究OA北大核心CSTPCD

Exploration of dry eye treatment plan for high-altitude military personnel

中文摘要英文摘要

目的 探究改良睑板腺按摩联合超声雾化及药物治疗高原官兵眼干燥症的疗效及其安全性.方法 选取2022年7-10月中部战区总医院医疗队诊治的驻西藏林芝(平均海拔3100 m)官兵眼干燥症患者180例(360眼)作为研究对象,按病程将患者分为4个区组(<1个月、1~3个月、3~6个月、≥6个月),分别将各区组内的患者采用随机数字表法随机均分为对照组、传统组及改良组(n=60).对照组给予常规治疗(人工泪液滴眼和雾化熏蒸);在常规治疗基础上,传统组行传统睑板腺按摩,改良组行改良睑板腺按摩.疗程3个月.比较3组患者治疗后的症状与体征评分、总有效率、治疗时间及不良事件发生率.结果 3组治疗前后组内对比,除对照组症状评分差异无统计学意义(P>0.05)外,其他评分均明显下降(P<0.05).治疗后3组间比较,传统组与改良组评分均明显优于对照组(P<0.05);传统组与改良组症状及体征评分差异无统计学意义(P>0.05).与对照组比较,传统组与改良组的总有效率均明显增高(P<0.01);传统组与改良组间总有效率比较差异无统计学意义(P>0.05).3组治疗时间比较,改良组治疗时间较对照组明显延长(P<0.05),但较传统组明显缩短(P<0.05).与传统组比较,改良组不良事件发生率明显降低(P<0.001).结论 在高原地区,改良睑板腺按摩联合雾化及局部药物治疗眼干燥症安全有效,操作简便,适合在官兵野训中推广应用.

Objective To explore the efficacy and safety of modified meibomian gland massage combined with ultrasonic atomization and drug therapy for dry eye in high-altitude military personnel.Methods A total of 180 patients(360 eyes)with dry eye who were diagnosed and treated by the medical team of General Hospital of Central Theater Command of Chinese PLA from July to October 2022 in Linzhi,Tibet(average altitude of 3100 meters)were selected as the research subjects.Patients were divided into four block groups based on the course of the disease:<1 month,1-3 months,3-6 months,and≥6 months,and each block group was randomly assigned to control group,traditional group and modified group by random number table method,with 60 cases in each group.Control group received routine treatment(artificial tear drops and atomization fumigation);on the basis of routine treatment,traditional group underwent traditional meibomian gland massage,and modified group underwent modified meibomian gland massage.After 3 months of treatment,the scores of symptoms and signs,total effective rate,duration of treatment and incidence of adverse events were compared among the 3 groups.Results In the intra-group comparison before and after treatment,except for control group's symptom scores difference which was not statistically significant(P>0.05),all other scores decreased significantly(P<0.05).In the inter-group comparison after treatment,the scores of both traditional group and modified group were significantly better than those of control group(P<0.05),but no significant difference was observed in symptom and sign scores between traditional and modified groups(P>0.05).Compared with control group,the total effective rates of traditional group and modified group both significantly increased(P<0.01),but there was no significant difference in total effective rate between traditional and modified groups(P>0.05).The treatment time in modified group was significantly longer than that in control group(P<0.05),but significantly shorter than that in traditional group(P<0.05).The incidence of adverse events was significantly lower in modified group than that in traditional group(P<0.001).Conclusion In high-altitude areas,modified meibomian gland massage combined with ultrasonic atomization and local drug therapy for dry eye is safe and effective,non-invasiveness and easy to perform,and suitable for promoting and application in military field training.

张鹏程;朱静宜;代含静;陈礼彬;鲍雨萌;曾波

解放军中部战区总医院眼科,湖北武汉 430000

临床医学

眼干燥症高原部队改良睑板腺按摩

ophthalmoxerosishigh altitudetroopsmodified meibomian gland massage

《解放军医学杂志》 2024 (007)

733-738 / 6

10.11855/j.issn.0577-7402.0811.2023.1129

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