KTP泪道激光术后泪道内灌注不同药物的效疗比较

发布时间：2018-09-06 09:15

【摘要】： 目的：通过对KTP泪道激光术后泪道内灌注不同药物疗效的比较找到提高泪道激光术疗效的方法。方法：选择2008年10月至2009年12月,在延边大学附属医院就诊的各种泪道阻塞的患者共114名。随机选择分为3组,每组40眼。泪道激光后向泪道内注入不同的药物(1)A组KTP泪道激光术后应用丝裂霉素+透明质酸钠(2)B组KTP泪道激光术后应用丝裂霉素+妥布霉素地塞米松眼膏：(3)C组KTP泪道激光术后单纯应用妥布霉素地塞米松眼膏。观察3个月以上,比较分析最终结果。判定疗效：治愈：术后溢泪消失,泪道冲洗通畅；好转：术后溢泪症状缓解,加压泪道冲洗通畅；无效：术后溢泪或溢脓,泪道冲洗不通畅结果：A组治愈34只眼(85.0%),好转2只眼,总有效率90.0%。B组治愈35只眼(87.5%),好转3只眼,总有效率95.0%。C组治愈26只眼(65.0%),好转2只眼,总有效率70.0%。 (1)A组治愈34只眼,B组治愈35眼,两组比较无统计学差异(P=0.745,P0.05)；A组总有效36只眼,B组总有效38只眼,两组比较无统计学差异(P=0.396,P0.05)。 (2)A组治愈34只眼,C组治愈26眼,两组比较有统计学差异(P=0.039,P0.05)；A组总有效36只眼,C组总有效28只眼,两组比较有统计学差异(P=0.025,P0.05)。A组疗效好于C组。 (3)B组治愈35眼,C组治愈26眼,两组比较有统计学差异(P=0.018,P0.05)；B组总有效38只眼,C组总有效28只眼,两组比较有统计学差异(P=0.003,P0.005)。B组疗效好于C组。结论：1、泪道激光术联合应用浓度为0.4 mg/ml丝裂霉素C,可以防止泪道创面阻塞,显著提高手术疗效。 2、泪道激光术后,丝裂霉素联合使用妥布霉素地塞米松眼膏或透明质酸钠无不良反应,治疗效果满意,是临床值得推广应用的理想治疗方法。 3、泪道激光术后应用浓度为0.4 mg/ml丝裂霉素C,使用安全,短期未见药物引起的并发症,是丝裂霉素治疗的比较理想的治疗浓度。
[Abstract]:Objective: to find out the method of improving the effect of lacrimal duct laser by comparing the effect of different drugs in lacrimal duct after KTP lacrimal duct laser. Methods: 114 patients with various kinds of lacrimal duct obstruction were selected from October 2008 to December 2009. They were randomly divided into 3 groups with 40 eyes in each group. After lacrimal passage laser injection of different drugs into lacrimal duct (1) A group KTP lacrimal passage laser operation with mitomycin hyaluronate sodium (2) B group KTP lacrimal duct laser with mitomycin tobramycin dexamethasone eye ointment: (3) group C KTP lacrimal passage stimulation Tobramycin dexamethasone eye ointment was used only after photosurgery. After 3 months of observation, the final results were compared and analyzed. Curative effect: cure: lacrimal discharge disappeared after operation, lacrimal passage flushed unobstructed; improvement: relief of lacrimal overflow symptoms, smooth flushing of pressurized lacrimal duct; invalidity: after operation, lacrimal overflow or abscess, The results showed that 34 eyes (85.0%) were cured, 2 eyes were improved, 35 eyes (87.5%) were cured in group 90.0.B, 3 eyes were improved, 26 eyes (65.0%) were cured and 2 eyes were improved in group 95.0.C. The total effective rate was 70. 0%. (1) 35 eyes of 34 eyes were cured in group A and 35 eyes were cured in group B, there was no significant difference between the two groups (P < 0. 745). The total effective rate of group A was 36 eyes and the total effective rate of group B was 38 eyes. There was no significant difference between the two groups (P < 0. 396p 0.05). (2). In group A, 34 eyes were cured in group C, 26 eyes were cured in group C, and there was statistical difference between the two groups (P < 0. 039 卤0. 05). The total effective effect of group A was 36 eyes (group C), and the total effective effect was 28 eyes in group C (P < 0. 039). The curative effect of group A was better than that of group C. (3) 35 eyes were cured in group B and 26 eyes were cured in group C, there was statistical difference between the two groups (P < 0.05). There was statistical difference between the two groups (P 0.003 P 0.005). The curative effect of group B was better than that of group C. ConclusionThe combined use of 0.4 mg/ml mitomycin C in lacrimal duct laser surgery can prevent lacrimal duct wound obstruction and significantly improve the curative effect after lacrimal passage laser surgery. Mitomycin combined with tobramycin dexamethasone eye ointment or sodium hyaluronate had no adverse effects. It is an ideal treatment method worth popularizing in clinic. 3. After lacrimal duct laser surgery, the concentration of mitomycin C is 0.4 mg/ml. It is safe to use, and there is no complication caused by drugs in a short period of time. It is an ideal therapeutic concentration for mitomycin treatment.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.63

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