泪道内镜与Nd-YAG泪道激光机对泪道阻塞性疾病的疗效对比分析

Comparative Analysis on the Curative Effects of Lacrimal Endoscope and Nd-YAG Lacrimal Laser in the Treatment for Lacrimal Duct Obstruction Diseases

目的探究并比较泪道内镜与Nd-YAG泪道激光机对泪道阻塞性疾病的临床疗效。方法选取成都铁路分局医院自2010年3月至2013年3月收治的泪道阻塞性疾病患者90例(100眼)作为临床研究对象,按随机数字表法将患者分为泪道内镜组和Nd-YAG泪道激光机组,每组45例(50眼)。泪道内镜组患者采用内镜下泪道钻通联合置管术进行治疗,Nd-YAG泪道激光机组患者采用激光联合环形置管术进行治疗。观察并对比两种手术方法的疗效、术后不良反应发生率以及伤口愈合情况。结果泪道内镜组患者的总有效率显著高于Nd-YAG泪道激光机组(86.0%vs 58.0%)(P<0.05);泪道内镜组患者切口影响外观率显著低于Nd-YAG泪道激光机组(10.0%vs 36.0%),泪道内镜组患者疗效以及切口愈合情况显著优于Nd-YAG泪道激光机组,且不良反应发生率显著低于Nd-YAG泪道激光机组(8.0%vs 34.0%)(P<0.05)。结论内镜下泪道钻通联合置管术治疗泪道阻塞性疾病相对于激光联合置管术治疗而言,具有显著优势,不仅提高了治愈率,还减少了术后不良反应的发生率及对患者外观的损伤。

Objective To compare the clinical efficacy of lacrimal endoscope and Nd-YAG laser in the treatment for lacrimal duct obstruction diseases. Methods A total of 90 cases （ 100 eyes） of patients with lacrimal duct obstruction diseases admitted in Chengdu Railway Bureau Hospital from Mar. 2010 to Mar. 2013 were selected as clinical research objects ,and divided into the lacrimal endoscope group and Nd-YAG laser group according to the random number table, with 45 cases （ 50 eyes） in each group. Patients in lacrimal endoscope group were treated with endoscopic lacrimal drilled through joint with catheter insertion, while patients in Nd-YAG laser group were treated with laser joint with circular catheter insertion. The efficacy, postoperative incidence of adverse reactions, and wound healing status of the two groups was observed and compared. Results The total effect rate of lacrimal endoscope group was significantly higher than that of Nd-YAG laser group（86.0% vs 58.0% ） （P 〈0.05） ; the ratio of wounds that affect the patients＇ appearance of lacrimal endoscope group was significantly lower than that of Nd-YAG laser group （ 10. 0% vs 36.0% ） ,the efficacy and the wound healing status of lacrimal endoscopegroup was significantly better than that of Nd-YAG laser group, and the incidence of adverse events of lacrimal endoscope group was significantly lower than that of Nd-YAG laser group（8.0% vs 34.0% ） （ P 〈 0.05 ）. Conclusion Endoscopic lacrimal drilled through joint with catheter insertion has significant advantage over laser joint with catheter insertion in the treatment for lacrimal duet obstruction diseases, which can not only improve the cure rate, but also reduce the incidence of postoperative adverse reactions and damage to the appearance of the patient.