不同泪道成形术式治疗单纯性鼻泪管阻塞疗效观察  

The clinical effectiveness of treating primary nasolacrimal duct obstruction by different techniques of lacrimal duct plasty

作　　者：陈光[1] 张弛[1] 李丹[1] 李军[1] 赵越[1] 

机构地区：[1]河北大学附属医院眼科,保定071000

出　　处：《中国实用眼科杂志》2015年第9期1025-1028,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 观察并比较激光泪道成形、激光泪道成形联合置管、泪道探通联合置管三种术式治疗原发性鼻泪管阻塞的手术疗效.方法 回顾性系列病例研究.收集2009年2月至2014年6月在河北大学附属医院行泪道成形手术的260例（272只眼）原发性鼻泪管阻塞患者的病历资料.根据泪道成形术式分为三组：A组术式激光泪道成形术,B组术式泪道探通术联合泪道置管术,C组术式激光泪道成形术联合泪道置管术.所有联合置管手术的患者均3个月拔管.A组术后随访6个月,B组和C组拔管后随访6个月,统计手术成功率.结果 6个月时的随访结果：三组患者手术总有效率68.38％ （186/272眼）,A组、B组、C组手术有效率分别为31.43％（22/70眼）、79.78％（71/89眼）、82.30％ （93/113眼）.A组与C组手术有效率差异有统计学意义（x2=47.905,P=0.000）,B组和C组的手术有效率差异无统计学意义（x2=0.208,P=0.648）.三组患者术后均未出现严重并发症.结论 泪道成形术是治疗原发性鼻泪管阻塞的安全、有效的术式.激光泪道成形术在联合泪道置管术后其成功率有明显提高.在联合泪道置管的情况下,泪道探通术与激光泪道成形术成功率差异无统计学意义。Objective To investigate and compare the clinical effectiveness of lacrimal duct plasty by laser, probing of lacrimal passage combined with lacrimal intubation and laser lacrimal duct plasty combined with lacrimal intubation on the treatment of primary nasolacrimal duct obstruction （PNLDO）.Methods In this retrospective cases series, 260 patients （272 eyes） with primary nasolacrimal duct obstruction were treated by lacrimal duct plasty in the affiliated hospital of Hebei university between February 2009 and June 2014.These patients were divided into three groups by techniques of lacrimal duct plasty： Group A were treated by lacrimal duct plasty by laser, Group B were treated by probing of lacrimal passage combined with lacrimal intubation and Group C were treated by laser lacrimal duct plasty combined with lacrimal intubation.Silicone tube was removed at 3 months in Patients with tube intubation.Effective rates were analyzed at 6 months after surgery or tube removal.Results After follow up for 6 months, the complete effective rate was 68.38% （186/272 eyes）, the effective rates of group A, group B and group C were 31.43%（22/70 eyes）, 79.78%（71/89 eyes） and 82.30% （93/113 eyes） respectively.There was statistical difference in effective rate between group A and group C （x2=47.905, P =0.000）, and there was no markedly differential in effective rate between group B and group C （x2=0.208, P =0.648）.Severe complications were not found after the surgery.Conclusions Lacrimal duct plasty is an effective and nontraumatizing procedure for the treatment of primary nasolacrimal duct obstruction.The success rate of laser lacrimal duct plasty was raised obviously after combining with lacrimal intubation.After combining with lacrimal intubation, there is no markedly differential in effective rate between probing of lacrimal passage and laser lacrimal duct plasty.

关 键 词：鼻泪管阻塞 激光泪道成形术 泪道探通术 泪道置管术 

分 类 号：R777.2[医药卫生—眼科]