三种不同手术方式治疗泪小管炎的疗效对比  

Comparative of different surgical methods in treatment of dacryocystitis

作　　者：孙雯 袁鹂[1] 张晓俊[1] SUN Wen;YUAN Li;ZHANG Xiao-jun(Department of Ophthalmology,the Second Affiliated Hospital of Nanjing Medical University,Nanjing 210003,Jiangsu,China)

机构地区：[1]南京医科大学第二附属医院眼科,江苏南京210003

出　　处：《川北医学院学报》2023年第5期697-700,共4页Journal of North Sichuan Medical College

摘　　要：目的:对比分析不同手术方式治疗泪小管炎的疗效。方法:选取行手术治疗的150例(150眼)泪小管炎伴结石患者作为研究对象。按照手术方式不同分为A、B、C组,每组各50例(50眼)。A组采用经泪点刮除结石置管术;B组采用经泪点水平切开泪小管刮除结石置管术;C组采用经睑结膜垂直切开泪小管刮除结石置管术。术后3个月,对各组患者进行疗效评价,对比术后并发症情况。结果:A组的临床有效率低于B组或C组,差异均有统计学意义(P<0.05);C组治愈患者比例高于A组或B组,B组好转患者比例高于C组,差异均有统计学意义(P<0.05)。各组术后并发症的总发生率比较,差异无统计学意义(P>0.05)。结论:与未行泪小管切开的刮除结石置管术比较,切开泪小管刮除结石置管术治疗泪小管炎,能够达到更高的临床有效率,而经睑结膜垂直入路的治愈率高于经泪点入路,有助于保留泪点功能、减少术后溢泪。Objective:To compare the effects of different surgical methods on dacryocystitis.Methods:150 patients(150 eyes)with dacryocystitis complicated with calculus treated with operaion were selected as the study subjects.The patients were divided into group A,group B,and group C,with 50 cases(50 eyes)in each group.In group A,the calculi were removed through lacrimal punctum,in group B,the calculi were removed through horizontal incision of lacrimal tubule through the lacrimal punctum,and in group C,the calculi were removed through vertical incision of the lacrimal tubule through eyelid conjunctiva.3 months after operation,the therapeutic effects among the patients in groups were evaluated and the postoperative complications were compared.Results:The clinical efficiency of group A was lower than that of group B or group C,and the differences were statistically significant(P<0.05).The proportion of patients with“cured”effect in group C was higher than that in group A or group B,and the proportion of patients with“improved”effect in group B was higher than that in group C,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of postoperative complications among the groups(P>0.05).Conclusion:Compared with the curettage and catheterization without lacrimal tubule incision,the treatment of dacryocystitis with incision of lacrimal tubule combined with curettage and catheterization can achieve a higher clinical efficiency.The cure rate of the vertical approach through the eyelid conjunctiva is higher than that through lacrimal punctum,which has a positive significance for preserving the function of lacrimal punctum and reducing postoperative epiphora.

关 键 词：泪小管炎 泪小管切开 刮除结石置管术 经泪点 经睑结膜 

分 类 号：R777.2[医药卫生—眼科]