泪道激光成形术联合泪道植管术治疗泪道阻塞的效果研究

Therapeutic effect of laser dacryocystoplasty combined with drainage tube implantation on lacrimal duct obstruction

目的探讨泪道激光成形术联合泪道植管术治疗泪道阻塞的效果。方法抽取濮阳市第二人民医院2018年9月至2021年10月收治的泪道阻塞患者158例,按随机数表法分为植管组与激光组,每组79例(138眼)。激光组采用泪道激光成形术,植管组采用泪道激光成形术联合植管术。比较两组临床治疗效果、泪膜破裂时间、泪液分泌量、泪液内神经肽P物质、干眼症状及并发症发生率。结果植管组总有效率(94.93%,131/138)高于激光组(79.71%,110/138),P<0.05;术后1个月,植管组泪膜破裂时间、泪液分泌量与激光组比较差异未见统计学意义(P>0.05);术后1个月,植管组泪液内神经肽P物质多于激光组(P<0.05),干眼症状评分低于激光组(P<0.05)。植管组并发症发生率(7.59%,6/79)与激光组(8.86%,7/79)比较差异未见统计学意义(P>0.05)。结论泪道激光成形术联合植管术治疗泪道阻塞可提高治疗效果,对眼表无显著影响,能增加泪液内神经肽P物质,改善干眼症状,且并发症发生率较低。

Objective To investigate the effect of laser dacryocystoplasty combined with drainage tube implantation in the treatment of lacrimal duct obstruction.Methods A total of 158 patients with lacrimal duct obstruction treated in Puyang Second People’s Hospital from September 2018 to October 2021 were selected,and they were divided into tube implantation group and laser group by random number table method,with 79 patients(138 eyes)in each group.Lacrimal duct laser was used in the laser group,and laser dacryocystoplasty combined with drainage tube implantation was used in tube implantation group.The clinical treatment effect,tear film rupture time,tear secretion,substance P in tear,dry eye symptom and complication rate were compared between the two groups.Results The total effective rate of tube implantation group(94.93%,131/138)was higher than that of laser group(79.71%,110/138),P<0.05.One month after operation,there was no significant difference in tear film rupture time and tear secretion between the tube implantation group and the laser group(P>0.05).One month after operation,the neuropeptide P level in the lacrimal fluid of the tube implantation group was higher than that of the laser group(P<0.05),and the symptom score of dry eye in the tube implantation group was lower than that in the laser group(P<0.05).There was no significant difference in the complication rate between the tube implantation group(7.59%,6/79)and the laser group(8.86%,7/79),P>0.05.Conclusions Laser dacryocystoplasty combined with drainage tube implantation,in the treatment of lacrimal duct obstruction,can improve the treatment effect,without significant impact on ocular surface.Moreover,it can increase the neuropeptide substance P in tears,and improve dry,with low incidence of complications.