泪道激光与内窥镜下泪道钻通联合置管术治疗慢性泪囊炎的疗效比较  

Comparison of the clinical effect of dacryocystoplasty with lacrimal endoscopy combined with intubation on chronic dacryocystitis

作　　者：沈降 王骥 文丰 吴国海 周宏健 

机构地区：[1]宁波市眼科医院,浙江315040

出　　处：《眼科》2011年第3期189-191,共3页Ophthalmology in China

摘　　要：目的观察并比较泪道激光联合置管术与内窥镜下泪道钻通联合置管术治疗慢性泪囊炎的临床疗效。设计比较性病例系列。研究对象选择2008年3月至2009年3月在宁波市眼科医院诊治的慢性泪囊炎患者90例(108眼)。方法 48例(58眼)慢性泪囊炎患者行泪道激光联合环形置管术,42例(50眼)慢性泪囊炎患者行内窥镜下泪道钻通联合环形置管术。术后常规处理,3个月后拔除硅胶管,随访12个月。观察并比较两种术式的临床疗效和并发症。主要指标临床疗效和并发症。结果施行泪道激光联合置管术的48例(58眼)患者中治愈42眼(72.4%),显效11眼(19.0%),无效5眼(8.6%);而内窥镜下泪道钻通联合置管术42例(50眼)患者中,治愈39眼(78.0%),显效8眼(16.0%),无效3眼(6.0%),两者差异无统计学意义(χ2=0.521,P=0.841)。两种术式术中、术后均无严重并发症。结论泪道激光联合置管术与内窥镜下泪道钻通联合置管术治疗慢性泪囊炎均安全、有效,因前者更经济,适宜在基层医院推广。Objective To investigate and compare the clinical effect of dacryocystoplasty and lacrimal endoscopy combined with intubation on chronic dacryocystitis. Design Comparative case series. Participants 90 patients （108 eyes） with chronic dacryocystitis were enrolled for the surgery. Methods 48 patients （58 eyes） were treated by KTP laser combined with silicone intubation. 42 patients （50 eyes） were treated by lacrimal endoscopy combined with silicone intubation. After operation the tubes were kept in place for three months. The follow-up time was 12 months. Main Outcome Measures The clinical effect and complications was analyzed and compared. Results Symptoms of the patients treated by KTP laser combined with silicone intubation were completely resolved in 42 eyes （72.4%）, improved in 11 eyes （19.0%）, and recurred in 5 eyes （8.6%）, respectively; and the patients treated by lacrimal endoscopy combined with silicone intubation were completely resolved in 39 eyes （78.0%）, improved in 8 eyes （16.0%）, and recurred in 3 eyes （6.0%）, respecivtely. There is no significant difference in the clinical effect of the two surgeries （X^2=0.521, P=0.841）. And there was no intraop- erative and postoperative complications during the follow-up time. Conclusions It is safe and effective for the patients with chronic dacryocystitis to be treat by whether KTP laser or lacrimal endoscopy combined with silicone intubation, and the former was more inexpensive and easily popularized in the basic hospital. （Ophthalmol CHN, 2011, 20： 189-191）

关 键 词：慢性泪囊炎 泪道内窥镜 泪道激光 硅胶管植入 

分 类 号：R779.6[医药卫生—眼科]