泪道激光成形术联合顺行置入RS型泪道支架和逆行置入球囊型泪道支架治疗泪道阻塞的疗效对比  

Comparison of the efficacy of laser lacryocystoplasty combined with antegrade implantation of RS - type lacrimal duct stents and retrograde implantation of balloon - typle lacrimal duct stents to treat lacrimal duct obstruction

作　　者：任梅[1] 肖津安[1] 朱江[1] 党晓洁 REN Mei XIAO Jin＇an ZHU Jiang DANG Xiaojie(Department of Ophthalmology, the Fourth Hospital of Xi＇an, Xi＇an, Shaanxi 710004, China)

机构地区：[1]西安市第四医院眼科,陕西西安710004

出　　处：《徐州医科大学学报》2017年第9期598-600,共3页Journal of Xuzhou Medical University

基　　金：陕西省自然科学基金面上项目（2014JM2-8174）

摘　　要：目的比较泪道激光成形术联合2种泪道支架置入治疗泪道阻塞的临床疗效。方法220例（220眼）泪道阻塞患者行泪道激光成形术联合泪道支架置入术。根据置入泪道支架的类型随机分为2组：A组（115眼）行逆行球囊型泪道支架置入，B组（105眼）行顺行Rs型泪道支架置入。术后随访6个月以上，比较2组间的临床疗效和并发症情况。结果B组在下泪管和泪总管阻塞的治愈率明显高于A组（83．33％VS．34．14％，P〈0．05）。B组在鼻泪管阻塞的治愈率明显高于A组（81．33％VS．64．10％，P〈0．05）。下泪管和泪总管阻塞治疗过程中2种治疗方法的并发症：A组术中严重出血2例，支架移位3例，引流不畅7例；B组泪小点过敏4例，皮下炎性硬结2例。A组总并发症发生率明显高于B组（17．39％vs．5．71％，P〈0．01）。结论泪道激光成形术联合顺行Rs型泪道支架置入对于泪道阻塞全程均有较好的临床疗效，同时由于并发症少，适合临床工作的普及。Objective To compare the therapeutic effect of a combination of laser lacryocystoplasty and two different implantation of lacrimal duct stents to treat lacrimal duct obstruction. Methods A total of 220 patients （220 eyes） with lacrimal duct obstruction underwent laser lacryocystoplasty combined with lacrimal duct stent implantation. Based on the stents implanted, the patients were randomly divided into two groups. Group A （115 eyes） was retrogradely implanted with balloon- type lacrimal duct stents, while Group B （105 eyes） was antegradely implanted with RS -type lacrimal duct stents. All the patients were followed - up over 6 months after operation. The clinical efficacy and complications were analyzed. Results Group B showed remarkably higher cure rates than Group A in the treatment of inferior lacrimal canaliculus and common canaliculus obstruction （83.33% vs. 34.14% , P 〈0.05）. Group B showed a marked higher cure rate than Group A in the treatment of nasolacrimal duct obstruction （81.33% vs. 64.10%, P 〈 0.05 ）. Group A reported two cases of serious bleeding during surgery, three cases of stent shifting and seven cases of inadequate drainage. In contrast, Group B reported two cases of hypersensitivity in the lacrimal punctum and four cases of subcutaneous poro- ma. Statistical difference was found as to total complication incidence between Group A and Group B （ 17.39% vs. 5.71%, P 〈 0.01 ）. Conclusion Laser lacryocystoplasty combined with antegrade implantation of RS -type lacrimal duct stents is an effective approach, with little complications.

关 键 词：泪道阻塞 RS型泪道支架 球囊型泪道支架 

分 类 号：R779.6[医药卫生—眼科]