泪道探通失败后鼻泪管阻塞治疗效果的影响因素分析  

Analysis on influencing factors for the therapeutic effect of nasolacrimal duct obstruction after the failure of lacrimal duct probing

作　　者：李彦娥 史永波 张俊广 刘雄 付艳广 孙然然 LI Yan-e;SHI Yong-bo;ZHANG Jun-guang;LIU Xiong;FU Yan-guang;SUN Ran-ran(Department of Otolaryngology,Wu’an First People’s Hospital,Wu’an Hebei 056300,China;Department of Ophthalmology,Wu’an First People’s Hospital,Wu’an Hebei 056300,China)

机构地区：[1]武安市第一人民医院耳鼻喉科,河北武安056300 [2]武安市第一人民医院眼科,河北武安056300

出　　处：《局解手术学杂志》2021年第9期795-799,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：河北省医学科学研究项目(20191660)。

摘　　要：目的探讨影响泪道激光联合逆行泪道置管术治疗泪道探通失败后鼻泪管阻塞治疗效果的因素。方法选择采用泪道激光联合逆行泪道置管术治疗泪道探通失败后鼻泪管阻塞的164例(185眼)患儿为研究对象,根据治疗效果,将患眼分为有效组(123眼)和无效组(62眼)。采用单因素及多因素Logisitic回归分析影响患者治疗效果的因素,并构建XGboost预测模型;受试者工作特征(ROC)曲线分析多因素Logisitic回归分析模型和XGboost模型对患者治疗效果的预测价值;比较2组患者治疗后的并发症发生情况。结果患者治疗有效率为66.49%。多因素Logisitic回归分析显示,年龄>30个月、病程>9个月、泪囊炎病史、脓性分泌物、复杂型鼻泪管阻塞、探通次数≥2次、严重感染均是影响患者治疗效果的独立危险因素。XGboost模型中按重要度评分由高到低依次为病程>9个月、复杂型鼻泪管阻塞、年龄>30个月、探通次数≥2次、泪囊炎病史、脓性分泌物、严重感染。XGboost模型的ROC曲线下面积、灵敏度、约登指数显著高于多因素Logisitic回归分析模型。有效组患者治疗后的并发症发生率显著低于无效组(P<0.05)。结论患者年龄>30个月、病程>9个月、泪囊炎病史、脓性分泌物、复杂型鼻泪管阻塞、探通次数≥2次、严重感染均是影响患者治疗效果的独立危险因素,临床应予以重视;XGboost模型对患者的治疗效果具有较高的预测价值。Objective To explore the factors affecting the therapeutic effect of lacrimal duct laser combined with retrograde lacrimal duct catheterization on children with nasolacrimal duct obstruction after the failed lacrimal duct probing.Methods A total of 164 children(185 eyes)with nasolacrimal duct obstruction after the failed lacrimal duct probing were treated with lacrimal duct laser combined with retrograde lacrimal duct catheterization.The affected eyes were divided into the effective group(123 eyes)and the ineffective group(62 eyes)according to the treatment effect.The univariate analysis and multivariate Logisitic regression analysis were performed to analyze the factors affecting the therapeutic effect of patients,and a XGboost prediction model was established;receiver operating characteristic(ROC)curve was used to analyze the predictive value of multivariate Logisitic regression analysis model and XGboost model for the treatment effect of patients.The incidence of complications after treatment in the two groups was compared.Results The effective rate of patients was 66.49%.The multivariate Logisitic regression analysis result showed that age>30 months,course of disease>9 months,history of dacryocystitis,purulent secretion,complex nasolacrimal duct obstruction,probing times≥2 and severe infection were all the independent risk factors affecting the treatment effect.In XGboost model,the importance scores of the influencing factors from high to low were the course of disease>9 months,complex nasolacrimal duct obstruction,age>30 months,probing time≥2,history of dacryocystitis,purulent secretion and severe infection in sequence.The area under ROC curve,sensitivity and Yoden index of the XGboost model were significantly higher than those of the multivariate Logisitic regression analysis model.The incidence of complications after treatment in the effective group was significantly lower than that in the ineffective group(P<0.05).Conclusion Age>30 months,course of disease>9 months,history of dacryocystitis,purulent s

关 键 词：泪道激光 逆行泪道置管 鼻泪管阻塞 XGboost模型 

分 类 号：R77[医药卫生—眼科]