【作者】 王玲；

【导师】 陶育纯；

【作者基本信息】 吉林大学 ， 公共卫生， 2013， 硕士

【摘要】 目的：干眼症是眼科的一种常见多发的眼表疾病，病人常表现为眼部干涩，异物感，畏光不适等。本研究是针对病因实施治疗及护理干预，睑板腺功能障碍明显好转，泪膜稳定性提高，有效改善干眼症状，减轻患者痛苦，提高干眼症患者生活质量。方法：研究对象为2012年1月—2013年5月吉林大学中日联谊医院新民院区眼科门诊就诊的确诊为睑板腺功能障碍并已导致蒸发过强型干眼症患者200例（400眼）。因各种原因，失访34例。按照随机原则分为实验组和对照组，对照组进行常规抗生素眼液及人工泪液点眼治疗4周，实验组除进行常规的抗生素眼水及人工泪液点眼4周，联合热敷、清洁睑缘、睑板腺按摩、饮食指导为主的护理干预，分别于治疗后1周，2周，4周，8周随访复诊，观察两组基础泪液分泌量测定、泪膜破裂时间测定、角膜荧光素染色、症状评分以及睑缘评分，并进行比较，应用SPSS13.0软件进行统计分析，P<0.05认为有统计学意义。结果：不同治疗时间实验组和对照组两组治疗前后各项指标比较均有所改善。（1）两组间比较治疗1周时，实验组基础泪液分泌量（SIT）平均为7.37±1.65mm，对照组为6.79±1.18mm，两组比较有统计学差异（P<0.05），而治疗后2周、4周、8周时，实验组平均基础泪液分泌量明显高于对照组，两组比较有显著统计学差异（P<0.001）；（2）治疗1周、2周、4周、8周时分别比较两组泪膜破裂时间（BUT），实验组明显较对照组延长，两组比较有显著统计学差异（P<0.001）；（3）治疗1周时，实验组症状评分平均为3.36±1.77，对照组为3.69±1.90，两组比较无统计学差异（P=0.209），而治疗后2周、4周、8周时，实验组平均干眼症状评分明显低于对照组，两组比较有显著统计学差异（P<0.05）；（4）比较治疗1周、2周、4周、8周，两组角膜荧光素染色，实验组明显低于对照组，两组比较有统计学差异（P<0.05）；（5）治疗1周时，实验组睑缘评分平均值高于对照组，两组比较有统计学差异（P<0.05），而治疗后2周、4周、8周时，实验组平均睑缘评分明显高于对照组，两组比较有显著统计学差异（P<0.001）。结论:1.对睑板腺功能障碍致蒸发过强型干眼症患者实施护理干预措施，基础泪液分泌量测定、泪膜破裂时间测定、角膜荧光素染色、症状评分及睑缘评分五方面优于单纯药物治疗。2.实施此护理干预措施的干眼症患者在基础泪液分泌量测定、泪膜破裂时间测定、角膜荧光素染色、症状评分及睑缘评分五方面均在治疗后1周优于单纯药物治疗，并且显示优势维持到8周以后。更多还原

【Abstract】 OBJECTIVE：Dry eye syndrome is the eye of a common ocular disease, patients oftencharacterized by ocular dryness, foreign body sensation, photophobia is notapplicable, and so on. This study is for etiological treatment and nursing interventionof meibomian gland dysfunction improved markedly, tear film stability increase,effective in improving symptoms of dry eye to reduce patient’s pain, and improve thequality of life of patients with dry eye syndrome.METHODS：The object of study was in January,2012-May,2013China-Japan unionhospital， Jilin University Xin-min courtyard area ophthalmology departmentoutpatient service seeing a doctor diagnosis and has caused for meibomian glandfunction barrier to over evaporate patient200examples (400eyes).Because of eachkind of reason, loses visits34examples. In accordance with the principle ofrandomly divided into an experimental group and control group,The treatmentgroup carries on the conventional antibiotic eye fluid and the artificial tear fluid eyetreatment, The control group eliminates carries on conventional the antibiotic eyewater and an artificial tear fluid eye, the union hot compress, the clean meibomianreason, meibomian gland massage, the diet instruction primarily nursingintervention, Separately in treats the latter1week,2weeks,4weeks,8week revisitsubsequent visits, observe two group of tear fluid secretion situation, the tearmembrane breakage time, the cornea dye as well as carry on meibomian glandfunction grading, and carries on the comparison, carries on the statistical analysisusing the SPSS13.0software, P<0.05thought has statistics significance.RESULTS：Around the different treatment time experimental group and the control grouptwo groups treats each target quite to be even has the improvement. During (1) two groups compares when treats1week, the experimental group foundation SchirmerⅠtest examination (SIT) average for7.37±1.65mm, the control group for6.79±1.18mm, two groups of comparisons has statistics difference (P<0.05),(2)treats1week,2week,4week, when8weeks separately compares two group of tearfilm break-up time (BUT), the experimental group compares the control group tolengthen obviously, two groups of comparisons have the remarkable statisticsdifference (P<0.001);(3) When treats1week, the experimental group symptomgrading average for3.36±1.77, the control group for3.69±1.90, two groupscompares the non-statistics difference (P=0.209), when treats latter2week,4week,8weeks, experimental group shape grading is lower than the control group obviously,two groups of comparisons have the remarkable statistics difference (P<0.05);（4）Compared with treats1week,2week,4week,8weeks, two group of corneafluorescence dye, the experimental group is lower than the control group obviously,two groups of comparisons have statistics difference (P<0.05);（5）When treats1week, the experimental group meibomian reason grading mean value compares thecontrol group to be high, two groups of comparisons have statistics difference (P<0.05), when treats latter2week,4week,8weeks, experimental group average jianreason grading is higher than the control group obviously, two groups ofcomparisons have the remarkable statistics difference (P<0.001).CONCLUSIONS：1. Evaporation caused by meibomian gland dysfunction is too strong of nursinginterventions in patients with dry eye syndrome, SchirmerⅠ test examinationand tear break-up time, corneal fluorescein staining, symptom score and lidmargin score are better than single drug therapy.2. Implementing this basic nursing interventions in patients with dry eye syndromeSchirmerⅠ test examination and tear film break time, corneal fluoresceinstaining, symptom score and lid margin score in1week after treatment is betterthan single drug therapy, and displayed until after8weeks.更多还原