联合植管治疗急性泪囊炎的临床观察

Clinical observation on combination of two kinds of silicone tubes implantation for treatment of acute dacryocystitis

目的:探讨联合两种硅胶管治疗急性泪囊炎的可行性和临床疗效。方法:本试验随机选取急性泪囊炎患者分两种方法进行治疗,治疗组A选取急性泪囊炎患者42例,入院立即行上泪道探通冲洗,并在行抗炎治疗后联合植入两种硅胶管分别扩张上下泪道,以通畅引流,术后定期冲洗,3～6mo后拔除硅胶管,并于拔管后随访6～12mo。治疗组B选取急性泪囊炎患者21例,行皮肤切开排脓,消炎治疗后行泪囊鼻腔黏膜吻合术,术后定期冲洗,随访6～12mo。效果评价采用多组有序分类资料的秩和检验,并发症组间比较采用两组二分类资料的方差分析,α=0.05。结果:治愈以恢复泪道解剖结构及功能为标准,治疗组A完全治愈率明显高于治疗组B,无效率明显低于治疗组B(P<0.05);治疗组A各并发症发生率明显低于治疗组B(P<0.05)。结论:泪道冲洗联合泪道双路硅胶管植入是治疗急性泪囊炎的有效方法,其效果明显优于传统治疗方法,可在微创条件下快速恢复泪道解剖结构及功能,并具有良好的远期疗效。

· AIM： To discuss the feasibility and clinical efficacy of combination of two kinds of silicone tubes implantation for treatment of acute dacryocystitis. · METHODS： Totally 63 eyes, suffering from acute dacryocystitis, were chosen from Huizhou First Hospital, and were randomly divided into two groups： group A （42 eyes） and group B （21 eyes）. In group A, patients were implanted two kinds of silicone tubes to expand both superior and lower lacrimal passage after irrigation and anti- inflammatory therapy, and silicone tubes were removed 3- 6 months later. Patients in group B were performed dacryocystorhinostomy after combination of surgical incision and drainage and anti- inflammatory therapy. All cases were then followed a clinical follow-up for 6- 12 month, given irrigation of ·acrimal passage regularly. We did statistical analysis to compare the effects and complications of two groups by way of Kruskal- Wallis Test or Chi-square test. RESULTS： The effective standard was based on anatomical structure and function of lacrimal abscess. Results showed that complete remission rate in group A was significantly higher than that in group B, while failure rate in group A was significantly lower than that in group B, and complication rate in group A was significantly lower than that in group B, P〈0.05.· CONCLUSION： Combination of irrigation of lacrimal passage and two kinds of silicone tubes implantation were effective to cure acute dacryocystitis, significantly better than traditional therapy, by which we can recover anatomical structure and function of lacrimal passage quickly, showing good long-term results.