单泪道置管与环形泪道置管联合泪道注药治疗泪道阻塞性疾病的比较

Efficiency and complications of single lacrimal duct intubation versus annular lacrimal duct intubation combined with drugs injection in lacrimal duct obstruction treatment

目的:比较单泪道置管与环形泪道置管联合泪道注入5-氟尿嘧啶和妥布霉素地塞米松眼膏治疗泪道阻塞性疾病的疗效和并发症。方法:收集2015-08/2016-09秦皇岛市海港医院眼科治疗的泪道阻塞患者74例92眼的临床资料进行研究。将患者随机分为A组和B组。在泪道探通成功后,A组(46眼)行单泪道置管术,B组(46眼)行环形泪道置管术并联合泪道注入5-氟尿嘧啶和妥布霉素地塞米松眼膏。观察两组患者的手术疗效和术后并发症。结果:A组患者术后治愈率61%,好转率22%,B组治愈率89%,好转率4%,B组疗效优于A组,差异有统计意义(P<0.05);术后A组发生并发症8眼,B组发生并发症2眼,两组患者并发症发生率比较差异有统计学意义(P<0.05)。结论:与单泪道置管相比,环形泪道置管联合泪道注入5-氟尿嘧啶和妥布霉素地塞米松眼膏治疗泪道阻塞性疾病疗效确切,术后并发症少。

AIM.. To evaluate the efficiency and single lacrimal duct intubation versus duct intubation with 5- fluorourac complications of annular lacrimal and tobramycin/ dexamethasone eye ointment injection in lacrimal duct obstruction treatment. METHODS. A total of 74 patients （92 eyes） with lacrimal duct obstruction who received surgical treatment by Department of Ophthalmology in Qinhuangdao Haigang Hospital were consecutively recruited between August 2015 and September 2016. They were randomly allocated to Group A or Group B. After probing of lacrimal passage, Group A （46 eyes） were treated by using single lacrimal duct intubation. Group B （46 eyes） were treated by using annular lacrimal duct intubation combined with 5 - fluorouracil and tobramycin/ dexamethasone eye ointment injection. Between the two groups, Mann- Whitney Rank sum test was used to comparing the operative effect, and Chi-square test was used to comparing the occurrence of complications. RESULTS：The cure rate was 61% in Group A and 89% in Group B; the improvement rate was 22% in Group A and 4% in Group B. Group B had better effect and less complications （2 cases） than Group A （8 cases）,thedifferences between the two groups were significantly （P〈0.05）. CONCLUSION. Compared with single lacrimal duct intubation, annular lacrimal duct intubation combined with 5- fluorouracil and tobramycin/dexamethasone eye ointment injection has better operative effect and less complication in lacrimal duct obstruction treatment.