目的：探讨妥布霉素地塞米松滴眼液联合双氯芬酸钠滴眼液对翼状胬肉患者术后炎症指标及复发的影响。

方法：回顾性研究。收集2021年5月至2024年5月我院收治的翼状胬肉患者102例102眼。所有患者均行翼状胬肉切除联合自体角膜缘上皮的结膜移位术，根据术后用药不同分为两组：观察组51眼术后给予妥布霉素地塞米松滴眼液联合双氯芬酸钠滴眼液治疗； 对照组51眼术后给予妥布霉素地塞米松滴眼液治疗，两组患者均治疗4 wk。术后随访6 mo，比较两组患者术后不同时间泪液中炎症因子水平、眼部症状评分、手术前后泪腺功能、用药期间不良反应情况及术后复发情况。

结果：观察组结膜瓣充血消退时间及角膜创面上皮消退时间均短于对照组(均P<0.001)。术后1、2、4 wk，两组患者泪液中白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平和眼部症状评分均较术后当天降低，且观察组均低于对照组(均P<0.05)。术后1 wk，两组患者首次泪膜破裂时间与术前相比缩短(P<0.05)，而两组泪液分泌试验(SⅠt)与术前相比无差异(P>0.05)； 术后2、4 wk，两组首次泪膜破裂时间及SⅠt与术前及术后1 wk相比增长，且观察组优于对照组(均P<0.05)。两组患者用药期间不良反应发生率比较无差异(7.8% vs 3.9%，P>0.05)。随访 6 mo，观察组复发率低于对照组，但无差异(3.9% vs 17.7%，P=0.051)。

结论：翼状胬肉患者术后应用妥布霉素地塞米松滴眼液联合双氯芬酸钠滴眼液治疗，较单独应用妥布霉素地塞米松滴眼液效果更好，有利于缓解术后炎症反应，提高患者舒适度，并能促进术后泪腺功能恢复，减少复发，且安全性较高。

METHODS: A retrospective study was conducted to collect the relevant data of 102 patients(102 eyes)with pterygium who were treated with tobramycin dexamethasone eye drops after pterygium excision and conjunctival transposition of autologous limbal epithelium from May 2021 to May 2024. They were divided into two groups according to different medication, including 51 eyes treated with tobramycin dexamethasone eye drops in control group and 51 eyes treated with tobramycin dexamethasone eye drops and diclofenac sodium eye drops in observation group, and both groups were treated for 4 wk. Followed-up for 6 mo, the levels of inflammatory factors at each time point, ocular symptom scores, lacrimal gland function, adverse reactions during the medication, and disease recurrence were compared.

RESULTS: The time required for conjunctival flap congestion and corneal wound epithelial regression in the observation group was shorter than that in the control group(all P<0.001). At 1, 2, and 4 wk after surgery, the levels of interleukin-6(IL-6), IL-1β, and tumor necrosis factor-α(TNF-α)in both groups decreased compared to the day of surgery, and the levels of each indicator in the observation group were lower than those in the control group at all time points(all P<0.05). At 1 wk after surgery, the time for the first tear film rupture in both groups was shortened compared to before surgery(P<0.05), while there was no statistical significant difference in the Schirmer I test(SⅠt)between the two groups compared to before surgery(P>0.05). At 2 and 4 wk after surgery, the time of first tear film rupture and the SⅠt in both groups increased compared to before and 1 wk after surgery, and the observation group was better than the control group(all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups of patients during medication(7.8% vs 3.9%, P>0.05). After a 6-month follow-up, the recurrence rate in the observation group was lower than that in the control group, but the difference was not statistically significant(3.9% vs 17.7%, P=0.051).

CONCLUSION: The combination of tobramycin dexamethasone eye drops and diclofenac sodium eye drops for postoperative treatment of pterygium patients is more effective than using tobramycin dexamethasone eye drops alone. It is beneficial for alleviating postoperative inflammatory reactions, improving patient comfort, promoting postoperative lacrimal gland function recovery, reducing recurrence, and has higher safety.