目的：基于跨理论模型(TTM)构建儿童干眼健康管理方案，探究该干预模式在儿童干眼临床管理中的实际应用价值。

方法：前瞻性研究，纳入2025年1月至2025年6月于眼科门诊确诊的干眼患儿，随机划分成对照组与管理组； 对照组予以临床常规干眼对症治疗，管理组在常规诊疗基础上叠加TTM健康管理干预，整体干预为期 6 mo。于治疗前及治疗后 1、3、6 mo，分别采用眼表疾病指数量表(OSDI)、干眼生活质量评分量表(DEQS)评估患儿主观症状； 并进行裂隙灯观察、泪膜破裂时间(BUT)、泪液分泌试验(SⅠt)、角膜荧光素染色(FL)及双通道视觉质量检测。记录以下指标：MTF截止空间频率(MTF cutoff)、斯特列尔比值(SR)、客观散射指数(OSI)，对比两组各项检测数据。

结果：完成管理随访的患者共235例，其中管理组118例，男64例，女54例，平均年龄11.31±1.92岁； 对照组117例，男60例，女57例，平均年龄11.08±1.85岁。治疗前两组的各项指标对比无统计学差异(均P>0.05)。治疗后1、3、6 mo，两组患儿的BUT、SⅠt、MTF cutoff、SR值均高于治疗前(均P<0.05)，OSDI、DEQS、FL、OSI值低于治疗前(均P<0.05)； 治疗后1 mo，两组的各项指标未见明显差异(均P>0.05)； 治疗后3、6 mo，管理组的BUT、SⅠt、MTF cutoff和SR较对照组显著增加，OSDI、DEQS、FL、OSI显著降低(均P<0.05)。

结论：以跨理论模型为核心的健康管理模式，能够改善患儿的眼表状态损伤，提高视觉质量，对巩固儿童干眼远期诊疗成效作用突出。

METHODS: This was a prospective study. Children diagnosed with dry eye disease in the ophthalmology outpatient department from January to June 2025 were enrolled and randomly assigned to a control group and a management group. The control group received routine symptomatic treatment for dry eye, whereas the management group received TTM-based health management interventions in addition to conventional treatment, with a total intervention duration of 6 mo. Subjective symptoms were assessed using the ocular surface disease index(OSDI)and Dry Eyerelated Quality of Life Score(DEQS)at baseline, 1-month, 3-month and 6-month follow-up visits. Slitlamp biomicroscopy, tear film break-up time(BUT), Schirmer's I test(SIt), corneal fluorescein staining(FL), and doublepass optical quality measurement were conducted. Modulation transfer function cutoff frequency(MTF cutoff), Strehl ratio(SR), and objective scattering index(OSI)were recorded. All outcome indicators were compared between the two groups.

RESULTS: A total of 235 children completed the follow-up, including 118 in the management group(64 males, 54 females; mean age 11.31±1.92 y)and 117 in the control group(60 males, 57 females; mean age 11.08±1.85 y). There was no significant difference in the indexes between the two groups before treatment(all P>0.05). At 1, 3, and 6 mo after intervention, BUT, SIt, MTF cutoff, and SR values were significantly increased in both groups compared with baseline, whereas OSDI, DEQS, FL, and OSI were significantly decreased(all P<0.05). At 1 mo posttreatment, there was no significant difference in the indexes between the two groups(all P>0.05). At 3 and 6 mo, the management group exhibited significantly higher BUT, SIt, MTF cutoff, and SR, as well as significantly lower OSDI, DEQS, FL, and OSI than the control group(all P<0.05).

CONCLUSION: The TTM-centered health management model can effectively improve the ocular surface status and visual function of pediatric dry eyedisease and relieve dry eye symptoms, which exerts a remarkable effect on consolidating the long-term therapeutic efficacy of pediatric dry eye.