三种置管用于治疗泪道阻塞效果比较

Comparison of three kinds of catheterization in the treatment of lacrimal duct obstruction

目的:比较采用泪道逆行置管、双套环顺行置管、泪道U形置管治疗泪道阻塞患者的治疗效果。方法:前瞻性研究。选取2015-07/2018-06在我院诊治的108例108眼泪道阻塞患者,随机分为三组,A组行泪道逆行置管术36例36眼,B组行双套环顺行置管术36例36眼,C组行泪道U形置管术36例36眼,术后随访6mo,比较三组患者术中出血量、手术时间、住院时间、治疗疗效以及并发症和泪道阻塞复发情况。结果:三组患者术中出血量、手术时间、住院时间比较差异有统计学意义(P<0.05)。A组的治疗总有效率为91.7%,B组为94.4%,C组为97.2%(P>0.05)。A组并发症发生率为11.1%,高于B组的5.6%,高于C组的2.8%(P=0.010);A组泪道阻塞复发率为9.1%,高于B组的5.9%,高于C组的5.9%(P=0.029)。结论:泪道逆行置管、双套环顺行置管、泪道U形置管用于治疗泪道阻塞患者的疗效均较高,术后发生并发症和泪道阻塞复发较少,但泪道逆行置管术可减少术中出血量、手术时间,泪道U形置管术可减少患者住院时间。

AIM:To compare the therapeutic effects of lacrimal duct retrograde catheterization,double loop antegrade catheterization,and lacrimal duct U-shaped catheter for patients with lacrimal duct obstruction.METHODS:Totally 108 patients with lacrimal duct obstruction who were treated in our hospital from July 2015 to June 2018 were selected as subjects and prospectively studied.They were randomly divided into three groups:A(36 cases),B(36 cases),and C(36 cases).In group A,lacrimal duct retrograde catheterization was performed.Group B was treated with double-loop antegrade catheterization.Group C was treated with lacrimal duct U-shaped catheterization.All patients were followed up for 6mo.The intraoperative basic conditions(Lntraoperative blood loss,operation time,hospital stay),treatment efficacy,and the occurrence of complications and recurrence of lacrimal duct obstruction of the three groups were compared.RESULTS:There were significant differences in the amount of intraoperative blood loss,operation time and hospital stay between the three groups(P<0.05).The total effective rate of treatment in group A was 91.7%,which was lower than 94.4%in group B and 97.2%in group C,but the difference in total effective rate between the three groups was statistically significant(P>0.05).The complication rate was 11.1%in group A,5.6%higher than that in group B,and higher than 2.8%in group C(P=0.010).The recurrence rate of lacrimal duct obstruction in group A was 9.1%,higher than 5.9%in group B,higher than that in group C(P=0.029).CONCLUSION:Retrograde catheterization of the lacrimal duct,double-loop antegrade catheterization,and lacrimal duct U-shaped tube for the treatment of patients with lacrimal duct obstruction have higher therapeutic effects,postoperative complications and less recurrence of lacrimal duct obstruction,but lacrimal passage Retrograde catheterization can reduce the amount of intraoperative blood loss,operation time,and U-shaped catheterization of the lacrimal duct can reduce the length of hospital stay,and can be widely used in clinical practice.