双泪小管置入式人工泪管置入术与鼻泪管支架置入术的临床疗效观察

发布时间：2018-07-14 08:33

【摘要】：目的：对双泪小管置入式人工泪管置入术与鼻泪管支架置入术在治疗慢性泪囊炎疾病的临床疗效观察，，探讨双泪小管置入式人工泪管置入术在临床应用中的优势以及推广价值。方法：收集2012年8月至2012年12月，北京爱尔英智眼科医院门诊就诊以及住院治疗慢性泪囊炎的患者76例（102只眼），按照术式分为两组，双泪小管置入式人工泪管置入术组（A组）42例（58只眼），鼻泪管支架置入术组（B组）34例（44只眼）。A组在局麻下行双泪小管置入式人工泪管置入术，术后常规泪道冲洗，共七天，之后定期泪道冲洗，术后3个月后拔管，抗炎眼药水点眼一周。B组在局麻下行鼻泪管支架置入术，术后常规泪道冲洗，共七天，之后定期泪道冲洗，术后3个月后拔管，抗炎眼药水点眼一周。随访1个月至5个月，平均约2.32个月。疗效判定：以泪道冲洗通畅与否及患者溢泪症状改善情况作为疗效评判标准，治愈：冲洗时无阻力感，泪道冲洗通畅，患者自觉溢泪症状消失。好转：冲洗时有阻力感，口鼻腔内有少许冲洗液；患者自觉溢泪症状减轻，但未完全消失。失败：冲洗时口鼻腔内无冲洗液流出，自原路或经上泪小点返流，患者自觉溢泪症状无改善或加重。采用SPSS17.0软件进行统计学分析，对2组的治疗效果应用χ2检验。上述统计分析均以P＜0.05作为统计学差异具有显著性意义。结果：两组患者均定期随访1个月至5个月，平均2.32个月，A组治愈40只眼，好转14只眼，无效4只眼，治愈率为93.10%。B组治愈23只眼，好转10只眼，无效11只眼，治愈率为75.00%。两组治愈率经过统计分析差异有统计学意义（χ2=7.41，P0.05）。术中部分患者有疼痛感，但均能耐受手术。术后1周少数患者鼻腔有血性分泌物，均未做特殊处理。结论：双泪小管置入式人工泪管置入术与鼻泪管支架置入术在治疗慢性泪囊炎上均有良好疗效。根据两组治愈率的比较，说明双泪小管置入式人工泪管置入术对于慢性泪囊炎的治疗效果更好，值得在临床上大范围推广，是慢性泪囊炎治疗的理想手段之一。
[Abstract]:Objective: To observe the clinical efficacy of double lacrimal canaliculus implantation and nasolacrimal duct stent placement in the treatment of chronic dacryocystitis, and to explore the advantages and popularization value of double lacrimal canaliculus implantation in the clinical application.
Methods: from August 2012 to December 2012, 76 patients (102 eyes) with chronic dacryocystitis were treated in the outpatient department of Beijing AI Ying Zhi ophthalmology hospital, and 102 eyes were hospitalized for chronic dacryocystitis. According to the operation, there were 42 cases (58 eyes) of the double lacrimal canaliculus implantation group (group A), and 34 cases (44 eyes) of the nasolacrimal duct stenting group (Group 44) in the local anesthesia group (group.A). The lacrimal duct implantation was performed for seven days after operation. After the operation, the lacrimal duct was flushed for seven days. After the operation, the lacrimal duct was flushed regularly. After 3 months, the tube was extubation. The anti inflammatory eye drops were placed under local anesthesia for one week. The lacrimal duct was rinsed after the operation for seven days. After the operation, the lacrimal duct was washed regularly. After 3 months after the operation, extubation and anti inflammatory ophthalmic medicine were used. Follow up for 1 months to 5 months, an average of about 2.32 months. The curative effect was judged by lacrimal passage irrigating or not and the improvement of the patient's spilled tears. The patient's conscious dacryocyst symptoms were relieved, but failed to disappear completely. Failure: no irrigating fluid in the mouth and nasal cavity in the rinse and reflux from the original or tacryo punctates. The patients consciously had no improvement or aggravation of the symptoms of the dacryocyst. Statistical analysis was carried out by SPSS17.0 software, and the effect of the 2 groups was tested by the chi 2 test. The above statistical analysis were all P < 0.05. It is significant for statistical difference.
Results: the two groups were followed up for 1 months to 5 months, with an average of 2.32 months, 40 eyes were cured in group A, 14 eyes were improved, 4 eyes were invalid, the cure rate was 23 eyes in group 93.10%.B, 10 eyes improved, and 11 eyes were invalid. The cure rate of group 75.00%. two was statistically significant (x 2=7.41, P0.05). Some patients in the operation were statistically significant (P0.05). There was pain, but they all tolerated surgery. A few patients had bloody secretions in the nasal cavity 1 weeks after operation, and no special treatment was done.
Conclusion: both lacrimal canaliculus implantation and nasolacrimal duct stent implantation have good curative effect in the treatment of chronic dacryocystis. According to the comparison of the cure rate of the two groups, it is proved that the treatment effect of the double lacrimal canaliculus implantation for chronic dacryocystitis is better, the value must be widely spread in the clinic, it is chronic dacryocystitis. One of the ideal means of treatment.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R779.6

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