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首页 > 学术期刊 > 国际眼科杂志 > 2002年1期 > 幹眼癥

幹眼癥

Dry Eeyes: Diagnosis and Management

幹眼癥是一種常見眼表疾病,病人至訴有幹澀感、畏光燒灼感、視物模糊、視力波動、不適感、异物感和易視疲勞等癥狀.以下臨床檢查有助于診斷:泪膜破裂時間,泪液分泌實驗和診斷染色(熒光素和虎紅染色),很多多實驗室檢查都有助于診斷,但由于儀器不足及費用過高,臨床上并不常采用.現今的治療有泪液成分的替代治瘵及保留泪液,但并不治本,而祗是緩解癥狀.用人工泪液和潤滑劑替代泪液以提高表面濕度,增加潤滑度及提高視銳度是目前應用最廣的療法.大多數制劑含防腐劑和表面毒性,長期使用,會導致并發癥.采用防腐性自由泪液是過去10年促進泪液替代的最重要方法.泪小黠封閉衍是保留泪液最有效最實用的瘵法,由硅膠、特氟隆和HEMA制作的泪小黠栓子植入垂直小管或水平小管.因為泪小黠栓子會游移及導致潜伏性并發癥,此法祗用于持續注入人工泪液臨床改善不明顯的病人.經常用口服制劑來促進泪液分泌,但因其潜在副作用,而且一旦腺體被廣泛破壞,剌激也產生不了很多泪液.紅腫腺體的刺激會在表面釋放炎癥的泪液,使病情惡化,慢性免疫介導的炎癥過程是導致幹眼癥發生的主要因素.局部環孢菌素A和局部用甲强龍有一定瘵效.性激素與泪液產生的關系復雜,全身性雌激素療法對幹眼癥病人有益.局部維生素A對伴有磷狀組織燮形和角質化的病人治療有效.自家血液療法對并有嚴重SPK及持續上皮缺陷的幹眼癥病人療效顯著,眼瞼中層注射毒杆菌毒素可以降低泪液的流失.雖然最近幹眼癥的治療主要是針對癥狀的,但對免疫介導病因學的了解日益提高,針對此方面的治瘵也益增多.

作 者：
M.S.Sridhar Merle Fernandes G.N.Rao  
作者单位：
印度海得拉巴市L.V.Prasad眼科研究所 
刊 名：
美中国际眼科杂志  ISTIC
英文刊名：
U.S. CHINESE JOURNAL OF OPHTHALMOLOGY 
年，卷(期)：
2002 2(1) 
分类号：
R77 
关键词：
幹眼 知识脉络  診斷 知识脉络  處理 知识脉络  Dry Eyes Diagnosis Managemen 知识脉络 
机标分类号：
R77 R24 
机标关键词：
人工泪液病人泪液分泌laboratory testssexual hormonesBotulinum toxindry eyevisual acuity診斷局部表面side effectsbreakup timeVitamin Atear film眼表疾病小管染色免疫泪膜破裂 
基金项目：
 
DOI：
 
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