本文選題：倒睫 + 淚膜��； 參考：《吉林大學》2010年碩士論文

【摘要】： 目的： 研究瞼內(nèi)翻倒睫所致的機械性損傷對角、結膜上皮細胞及淚膜穩(wěn)定性的影響,并對術后的相應改善情況進行分析。 方法： 臨床60例(106眼)瞼內(nèi)翻倒睫患者分三組：先天性瞼內(nèi)翻組(n=41),老年性瞼內(nèi)翻組(n=45),瘢痕性瞼內(nèi)翻組(n=20),所有患者術前、術后1周及術后1個月分別行淚液分泌試驗(schirmer test I, STI)、淚膜破裂時間(tear break-up time, BUT)、角膜熒光素染色(cornea fluorescein staining, CFS)及結膜印記細胞學(conjunctival impression cytology, CIC)檢查(根據(jù)Nelson分級),分別對比手術前后的淚膜功能狀態(tài),杯狀細胞密度及結膜上皮細胞鱗狀化生程度。 結果： (1)與術前相比較,三組瞼內(nèi)翻倒睫患者行矯正手術后1周及1個月的淚液分泌量無明顯變化(P0.05)。(2)三組瞼內(nèi)翻倒睫患者行矯正手術后與術前比較BUT明顯延長,差異均有顯著性統(tǒng)計學意義(P＜0.05)。以術后1周及1個月的實驗結果觀察,相對于瘢痕性瞼內(nèi)翻組的淚膜破裂時間(6.02±3.43s；6.34±6.86s)來說,老年性瞼內(nèi)翻組(8.95±3.75s：9.43±2.67s)及先天性瞼內(nèi)翻組(9.20±7.35s：10.01±3.32s)較長。(3)通過三組患者手術前、后角膜熒光染色比較可以看出,各組瞼內(nèi)翻倒睫患者行矯正手術后,角膜熒光素著色減輕甚至消失,角膜熒光素染色評分的均值均下降,絕大部分患者角膜恢復光滑透明,差異均有顯著性統(tǒng)計學意義(P0.05)。(4)先天性和老年性瞼內(nèi)翻患者術后的鱗狀化生程度都有不同程度的降低,杯狀細胞密度亦明顯增加,有顯著性意義(P0.05)。瘢痕性瞼內(nèi)翻患者術后鱗狀化生程度有所降低(P0.05)，，但杯狀細胞密度無明顯增加(P＞0.05)。 結論： 瞼內(nèi)翻倒睫所致的眼表機械性損傷可導致結膜上皮細胞鱗狀化生,杯狀細胞數(shù)量減少及淚膜穩(wěn)定性下降；及時且有效的瞼內(nèi)翻倒睫矯正術可明顯改善上述情況；相對于瘢痕性瞼內(nèi)翻來說,先天性瞼內(nèi)翻及老年性瞼內(nèi)翻矯正術后眼表功能恢復情況更好。
[Abstract]:Objective:To study the effects of mechanical injury induced by entropion on diagonal, conjunctival epithelial cells and lacrimal membrane stability, and to analyze the corresponding improvement after operation.Methods:60 patients with entropion and trichiasis were divided into three groups: congenital entropion group (n = 41), senile entropion group (n = 45) and scar entropion group (n = 20).Tear secretion tests were performed 1 week after operation and 1 month after operation respectively. Tear secretion tests were performed (according to Nelson grade, respectively). Tear break-up time, Butt time, fluorescein staining of cornea and conjunctival impression cytology (CICs) were performed respectively.The functional state of tear film before and after surgery,Goblet cell density and squamous metaplasia of conjunctival epithelial cells.Results:(1) there was no significant change in the amount of tear secretion in the three groups of patients with entropion and trichiasis one week and one month after orthodontic surgery. The BUT was significantly prolonged in the three groups after orthopedic surgery.The difference was significant (P < 0.05).As can be seen from the comparison of corneal fluorescence staining after corrective surgery, corneal fluorescein staining decreased or even disappeared, corneal fluorescein staining scores decreased, and most of the patients' corneas returned to smooth and transparent cornea.The difference was statistically significant (P 0.05). The degree of squamous metaplasia and goblet cell density in congenital and senile patients with entropion were decreased in different degrees, and the density of goblet cells was also significantly increased (P 0.05).The degree of squamous metaplasia decreased in patients with cicatricial entropion, but the density of goblet cells did not increase significantly (P > 0.05).Conclusion:Mechanical injury of eyelid surface caused by entropion could result in squamous metaplasia of conjunctival epithelial cells, decrease of goblet cells and decrease of tear film stability.Compared with cicatricial entropion, the recovery of ocular surface function was better after congenital entropion and senile entropion correction.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R779.6

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