观察KTP激光融通泪道阻塞后不同留置物的疗效对比

Observation of KTP laser fusion of lacrimal passage obstruction after different indwelling things comparison

目的:观察泪道激光融通泪道阻塞后不同留置物对不同部位泪道阻塞的治疗效果的差异,并对结果进行分析。方法:各种原因所致泪道阻塞179例299眼。按照病因分成泪小管阻塞组43例74眼,鼻泪管阻塞组82例134眼,泪小管合并鼻泪管阻塞组54例91眼。泪小管阻塞患者随机分成两组,留置硅胶管组37眼,留置丝线组37眼。鼻泪管阻塞患者随机分成3组:留置硅胶管组44眼;留置丝线组44眼,留置T型泪道支撑管组46眼。泪小管合并鼻泪管阻塞患者随机分成两组:留置丝线联合T型泪道支撑管组45眼,留置带泪小管扩张管的硅胶泪道留置管组46眼。分别留置硅胶管、丝线、T型泪道支撑管、带泪小管扩张管的硅胶管。随访3～6mo,观察泪道引流泪液功能的恢复情况,并将各种疗效对比分析。结果:泪小管阻塞患者留置丝线:治愈率89.2%,有效率8.1%;留置硅胶管:治愈率62.2%,有效率21.3%。鼻泪管阻塞患者,留置丝线组:治愈率52.3%,有效率34.1%;留置硅胶管组:治愈率59.1%,有效率34.1%;留置T型泪道支撑管组:治愈率80.4%,有效率8.7%。泪小管合并鼻泪管阻塞患者,留置丝线联合T型泪道支撑管组:治愈率82.2%,有效率6.67%;留置带泪小管扩张管的硅胶管组:治愈率60.9%,有效率19.6%。结论:临床结果提示,泪道阻塞留置物的选择应该根据泪道阻塞的部位、阻塞的严重程度、病程、治疗情况、患者的依从性等从多方面综合考虑,针对每位患者的具体情况,个性化选择,力求达到最佳的治疗效果。

AIM：To observe the difference of different intubation to obstruction of lacrimal passage after laser recanalisation and analyze it.METHODS：Totally there were 179 cases （299 eyes） with canalicular obstruction caused by various reasons. According to causes, cases were divided into three groups, among which 43 cases（74 eyes）were lacrimal canalicular obstruction group, 82 cases （134 eyes） were nasolacrimal duct obstruction group,54 cases（91 eyes） were lacrimal canalicular combined with nasolacrimal duct obstruction group. Lacrimal canalicular obstruction group was divided into two groups randomly：silicone intubation group 37 eyes, silk group 37 eyes. Nasolacrimal duct obstruction group was divided into three groups randomly：silicone intubation group 44 eyes, silk group 44 eyes, T-silicone intubation group 46 eyes. Lacrimal canalicular combined with nasolacrimal duct obstruction group was divided into two groups randomly：silk combined with T-silicone intubation group 45 eyes, silicone intubation with canalicular expansion tube group 46 eyes. The mean follow-up was 3-6 months, recovery of lacrimal passage drainaging tears function was observed and the therapeutic effect was compared among the groups.RESULTS：The curative and effective rates of the seven groups （lacrimal canalicular obstruction：silk group, silicone intubation group; nasolacrimal duct obstruction：silk group, silicone intubation group, T-silicone intubation group; lacrimal canalicular combined with nasolacrimal duct obstruction：silk combined with T-silicone intubation group, silicone intubation with canalicular expansion tube group） were 89.2% and 8.1%, 62.2% and 21.3%, 52.3% and 34.1%, 59.1% and 34.1%, 80.4% and 8.7%, 82.2% and 6.67%, 60.9% and 19.6% respectively.CONCLUSION：Clinical results show that the selection of indwelling things should based on the position, severity, course of disease, treatment conditions and compliance of the patient. In order to achieve the best curative effect, the indwelling things should be chosen personally according to specific condition of each patient.