鼻泪管支架植入术治疗不同类型泪道阻塞患者的疗效

Clinical Effect of Nasolacrimal Duct Stent Implantation for the Treatment of Different Kinds of Lacrimal Duct Obstruction Diseases

目的探讨鼻泪管支架植入术治疗不同类型泪道阻塞性疾病的临床疗效。方法选取2013年6月至2014年6月来宝鸡市中心医院进行治疗的236例泪道阻塞患者,按照随机数字表法分为试验组和对照组,各118例。其中试验组患者中将其按照泪道阻塞类型分为单纯性泪道阻塞(A组,53例)和慢性泪囊炎(B组,65例)。给予所有试验组患者鼻泪管支架植入手术。给予所有对照组患者外路泪囊鼻腔吻合术治疗。术后对两组患者进行为期3个月的随访。观察两组患者术后3个月的治疗有效率,评价鼻泪管植入术的治疗效果;并观察行鼻泪管植入术两组患者术后3个月术后并发症发生率,统计两组患者围术期指标。结果试验组和对照组患者术后3个月的治疗总有效率比较差异无统计学意义(P>0.05),术后3个月A组治疗总有效率显著高于B组[81.1%(43/53)比63.1%(41/65)](P<0.05);A、B两组患者术中泪道出血、术后泪囊区压痛和咽喉异物感的发生率比较差异无统计学意义(P>0.05),A组支架阻塞和泪总管再阻塞的发生率低于B组[13.2%(7/53)比30.8%(20/65),9.4%(5/53)比26.1%(17/65)](P<0.05)。试验组患者住院时间显著短于对照组患者[(3.3±0.9)d比(6.4±1.3)d,P<0.01],同时试验组患者对手术的美容满意度显著高于对照组患者[88.1%(104/118)比52.1%(62/118),P<0.01]。结论与慢性泪囊炎患者相比,单纯新泪道阻塞患者更适合于采用鼻泪管支架植入术进行治疗。

Objective To investigate the effect of tears nasolacrimal duct stent implantation for different types of lacrimal duets obstruction. Methods Total of 236 patiems with obstruction of lacrimal ducts in Bacji Central Hospital from Jun. 2013 to Jun. 2014 were included in the study and divided into a trial group and a con rol group,liB cases each. The trial group was further divided into group A（ simple lacrimal duct obstruction） and group B（ chronic dacryoeystitis） according to the obstruction type. Tears nasolacrimal duct stent implantation was applied to all patients of the trial group. External dacryocystorhinostomy was applied to all patients of the control group. A three-month follow-up was given to both groups. Treatment efficacy after 3 months was observed to evaluate the therapeutic effect of tears nasolacrimal duct stent implantation,perioper- ative index and incidence of 3-month postoperative complications of the two groups were observed. Results There was no significant difference in the treatment efficacy at three months after surgery between the trim group and control group（ P 〉 0. 05 ）. But significant difference appeared in the treatment efficacy between group A and group B[81.1% （43/53） vs 63. 1% （41/65） ,P 〈0. 05]. There was no significant difference in incidence of lacrimal duct hemorrhage and lacrimal sac region pain between group A and B （ P 〉 0. 05 ）. But significant difference appeared in the incidence of stem obstruction between group A and B[ 13.2% （7/ 53 ） vs 30. 8% （20/65） ,9. 4% （5/53） vs 26. 1% （ 17/65 ） ,P 〈 0. 05 ]. Length of stay of the trial group was significantly shorter than the control group [ （3.3 ± 0. 9 ） d vs （6. 4 ± 1.3 ） d, P 〈 O. O1 ]. Postoperative cos- metic satisfaction of the trial group was significantly higher than the control group[88. 1% （104/118） vs 52. 1% （62/118 ）, P 〈 0. 01 ]. Conclusion Compared with chronic dacryocystitis, simple lacrimal duct obstruction is suitable to be treated with tears nasolacrimal duct stent implantation.