泪道内窥镜联合激光硅胶管置入术治疗慢性泪囊炎的效果及影响因素分析  

Effect of lacrimal endoscopy combined with laser silicone tube implantation on chronic dacryocystitis and its influencing factors

作　　者：娄宾 Lou Bin(Department of Ophthalmology,Xuchang Central Hospital,Xuchang 461000,China)

机构地区：[1]河南省许昌市中心医院眼科,461000

出　　处：《中国实用医刊》2019年第14期73-76,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨泪道内窥镜联合激光硅胶管植入术治疗慢性泪囊炎的效果及影响因素.方法选择许昌市中心医院2016年1月至2017年12月收治的158例慢性泪囊炎患者作为研究对象,其中采用泪道内窥镜联合激光硅胶管置入术(DCR)治疗的92例患者作为观察组,采用泪囊鼻腔吻合术(DCR)治疗的66例患者作为对照组,比较两组患者的临床治疗效果,并对观察组患者的预后影响因素进行分析.结果对照组和观察组临床疗效比较差异未见统计学意义(P>0.05);观察组术中出血和术后眼睑水肿的发生率低于对照组(P<0.05).对于观察组患者,不同年龄和拔管时间对其临床疗效的影响比较差异有统计学意义(P<0.05);与41~60岁、>60岁患者比较,20~40岁患者痊愈人数明显减少(χ^2=9.874、11.276,P=0.002、0.001),无效人数明显增加(χ^2=12.796/、13.667,P=0.000、0.000);与术后3个月拔管患者比较,3~6个月拔管的患者痊愈人数明显减少(χ^2=5.867,P=0.015).结论泪道内窥镜联合激光硅胶管置入术治疗慢性泪囊炎临床有效率高,术后并发症少,相比传统DCR具有显著优势.充分考虑年龄对术后疗效的影响对评估预后有一定作用,而准确掌握拔管时间对提高临床疗效有重要意义.Objective To explore the clinical effect and influencing factors of lacrimal endoscopy combined with laser silicone tube implantation in the treatment of chronic dacryocystitis.Methods A total of 158 patients with chronic dacryocystitis admitted to Xuchang Central Hospital from January 2016 to December 2017 were selected as the study subjects.Among them,92 cases were treated by lacrimal endoscopy combined with laser silicone tube implantation as observation group,and 66 cases were treated by dacryocystorhinostomy(DCR)as control group.The clinical effects of the two groups were compared,and the influencing factors on the prognosis of patients in the observation group were analyzed.Results There was no significant difference in clinical efficacy between the control group and the observation group(P>0.05);the incidence of bleeding and eyelid edema in the observation group was lower than that in the control group(P<0.05).For the observation group,there were significant differences in the effect of different age and extubation time on the clinical efficacy(P<0.05);compared with 41 to 60-year-old and over 60-year-old patients,the number of recovery in 20 to 40-year-old patients decreased significantly(χ^2=9.874,11.276,P=0.002,0.001),and the number of invalid patients increased significantly(χ^2=12.796,13.667,P=0.000,0.000);compared with patients who had been extubated 3 months after operation,the number of patients who had been extubated 3 to 6 months after operation was significantly reduced(χ^2=5.867,P=0.015).Conclusions Compared with traditional DCR,endoscopic treatment of chronic dacryocystitis has high clinical efficiency and fewer complications,which has significant advantages.Comprehensive consideration on the influence of age on the outcome of surgery plays a certain role in evaluating the prognosis,and accurately master the extubation time is of great significance to improve the clinical efficacy.

关 键 词：慢性泪囊炎 泪道内窥镜 激光硅胶管置入术 影响因素 

分 类 号：R779.6[医药卫生—眼科]