球头硅胶管逆行泪道植管术治疗鼻泪道阻塞的疗效及影响因素分析

Curative effects and its related factors of retrograde intubation with ball-head silicone tube into lacrimal canal for nasolacrimal duct obstruction

目的 探讨球头硅胶管逆行泪道植管术治疗鼻泪道阻塞的疗效及其相关影响因素。方法 回顾性选择本院眼科就诊的已接受球头硅胶管逆行泪道植管术的92例（92眼）鼻泪道阻塞患者,排除泪小管阻塞、泪总管阻塞、泪点外翻等情况,记录性别、年龄及术前病情、术后疗效,统计分析其相关影响因素。结果 经术后随访6~12个月,92例鼻泪道阻塞患者中治愈77例（83.7%）,均无明显手术并发症发生。单因素分析发现,治愈组和欠佳组患者的性别、年龄差异均无统计学意义（均为P〉0.05）,而术前合并不同病情的患者其手术治疗效果差异有统计学意义（P=0.042）。Logistic逐步回归分析发现,性别、年龄与手术治疗效果均无相关性（均为P〉0.05）,而术前病情的三组中,与泪道损伤史病例对比,单纯鼻泪道阻塞与手术治愈率具有相关性（OR=5.343,P=0.032）。结论 利用球头硅胶管逆行泪道植管术治疗鼻泪道阻塞,成功率较高,且无明显手术并发症。术前充分考虑各种病情对手术的影响,可以进一步提高手术成功率。

Objective To analyze the curative effects and its related factors of retrograde intubation with ball-head silicone tube into lacrimal canal for nasolacrimal duct obstruction. Methods Ninty-two patients （92 eyes） with nasolacrimal duct ob- struction received ball-head silicone tubes retrograde intubation were selected retrospectively from department of ophthalmology of our hospital. Patients with lacrimal canalicular obstruction, lacrimal duct obstruction, punctum ectropion were excluded. Gender,age,preoperative conditions and curative effect were recorded. SPSS 15.0 was used to analyze the relevant factors. Results After 5 - 12 months follow-up,77 cases （83.7%） of 92 patients with nasolacrimal duct obstruction were cured. There was no significant complication in operation. Single factor analysis showed that there was no significant difference in gender,age between cured group and poor-cured group （ all P 〉 0.05 ）, but there was statistical difference between with or without preoperative condi- tions （P = 0.042）. Logistic regression analysis found that operation effect was not corre-lated with gender, age （ all P 〉 0.05 ）, but correlated with the three preoperative conditions such as comparison of simple nasolacrimal duct obstruction with lacrimal duct injury history （ OR = 5.343,P = 0. 032）. Conclusion The curative rate of retrograde intubation with ball-head silicone tube into lacrimal canal for nasolacrimal duct obstruction is high without obvious complication. Considering the preoperative conditions completely before operation can improve the success rate of operation further.