华西医学

华西医学

热脉动系统治疗睑板腺功能障碍的研究进展

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睑板腺功能障碍(meibomian gland dysfunction,MGD)是临床常见的眼表疾病,其发生发展与睑板腺结构和(或)功能异常密切相关。目前 MGD 常用的治疗方法包括物理治疗、局部使用人工泪液和眼表润滑剂、局部和(或全身)使用具有抗炎作用的抗生素和皮质类固醇激素、膳食补充 Ω-3 脂肪酸等。近些年来逐渐用于临床的热脉动系统 LipiFlow 可直接对上下眼睑的睑结膜面进行加热,同时从眼睑皮肤面对睑板腺进行脉冲式按摩,由于设计独特,在治疗时可有效避免对角膜及眼球的加热和挤压,大大提高了物理治疗的安全性和患者的依从性。大量临床研究显示 LipiFlow 治疗 MGD 的效果并不低于持续 3 个月、2 次/d 的传统热敷按摩,具有良好的临床应用前景。目前 LipiFlow 在国内的应用还未全面展开,只在部分医院有试验性的应用,该文就 LipiFlow 治疗 MGD 的研究进展作一综述。

Meibomian gland dysfunction (MGD) is a common ocular surface disease, and the pathogenesis of MGD is closely related to the alteration of meibomian gland morphology and (or) function. At present, the treatment strategy for MGD consists of physical therapy, artificial lubricants, topical and systemic antibiotics and anti-inflammatory agents, topical steroids and Ω-3 dietary supplementation. Recently, the thermal pulsation system (LipiFlow) has been used clinically, which allows heat to be applied to the palpebral surfaces of the upper and lower eyelids directly over the meibomian glands, while simultaneously applying pulsatile pressure to the outer eyelid surfaces. Due to its specific design, the cornea and eyeball can successfully avoid the potential damage from overheating and improper expression, which will greatly improve the safety during the clinical application and patients’ compliance. Studies have showed that the effectiveness of LipiFlow when treating MGD is at least as well as twice-daily lid warming and massage for 3 months, which displays a broad application prospect. At present, the application of LipiFlow in China has not been fully developed, and only some hospitals have experimental applications. This paper summarizes the research progress of LipiFlow treatment in MGD.

关键词: 睑板腺功能障碍; 物理治疗; 热脉动系统; 有效性; 安全性

Key words: Meibomian gland dysfunction; Physical therapy; Thermal pulsation system; Effectiveness; Safety

引用本文: 王蓉, 邓应平. 热脉动系统治疗睑板腺功能障碍的研究进展. 华西医学, 2018, 33(11): 1415-1419. doi: 10.7507/1002-0179.201809119 复制

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