球头硅胶管逆行泪道植管手术成功的预后因素分析

Predictors of retrograde intubation with ball-head silicone tube in patients with lacrimal drainage systemstenosis

目的探讨影响球头硅胶管逆行泪道植管治疗泪道阻塞患者预后相关因素的分析。方法回顾性分析本院2013年1月至2014年12月期间56只眼48例患泪道阻塞行球头硅胶管逆行泪道植管植入的患者。根据术后泪溢症状、泪湖高度以及泪湖高度，患者被分为成功与失败组。随访半年至1年，比较两组间患者临床检查和眼部各项指标间的差别。结果56只眼中治愈44只眼，成功率为78．6％。成功组与失败组比较，患者年龄、术前冲洗检测泪道通畅程度以及随访时间差异均有统计学意义（P=0．003，P=0．002，P=0．000），年龄和泪道冲洗通畅度在多重相关性分析中与术后是否成功呈显著相关（P〈0．01，P=0．005）。结论年龄与术前泪道冲洗是否通畅为泪道阻塞患者球头硅胶管植入术后成功的两个重要预后因素，即手术成功率高的患者中年龄更小以及术前泪道冲洗更为通畅，这两个因素可以作为手术医生考虑是否行为泪道阻塞患者行逆行球头泪道硅胶管植入术的评价指标。

Objective To evaluate prognostic factors about retrograde intubation with ball-head silicone tube in patients with lacrimaldrainage system stenosis. Methods A retrospective review was conducted on the clinical records of 48 patients（56 eyes）who had undergone retrograde intubation with ball- head silicone tube to treat lacrimal drainage system stenosis between January 2013 and December 2014. Patients were divided into two groups：a success group and a failure group,according to the disappearance of epiphora symptoms,normalization of tear meniscus height, and the easy passage of fluid without resistance on the postoperative syringing test. Patients had a mean follow-up period of 6 to 12 months. All Patient and ocular parameters were compared between the success and failure groups. Results Retrograde intubation with ball-head silicone tube was successful in 78. 6% of participants （44 eyes in 56 eyes）. Significant differences between the success and failure groups were found for age（P〈0. 001）, follow-up period（P〈0. 001） ,and degree of passage on the preoperative syringing test（P〈0.01）. Only age（P〈0.01）and degree of passage on the preoperative syringing test （P = 0. 005） remained significantly associated with ball-head silicone tube intubation success in multivariate analysis. Conclusion Age and the degree of passage on the preoperative syringing test are the two major predictors of retrograde intubation with ball-headed silicone tube success in patients with lacrimal drainage system. The success rate was higher in patients who showed younger and easy passage of fluid without resistance on the preoperative syringing test. These two factors should be considered by surgeons planning silicone tube intubation in patients with lacrimal drainage system stenosis.