泪道钻通术联合泪道置管术治疗慢性泪囊炎的疗效分析

Curative effects of lacrimal duct drill combined with lacrimal duct intubation on chronic dacryocystitis

目的探讨泪道钻通术联合泪道置管术治疗慢性泪囊炎的疗效。设计回顾性病例系列。研究对象2015年6月到2017年2月在海南医学院附属医院眼科收治的慢性泪囊炎患者98例。方法根据随机信封抽签原则分为观察组与对照组各49例,对照组给予泪道钻通术治疗,观察组给予泪道钻通术联合泪道置管术,术后随访3个月,记录并比较两组疗效、眼表症状评分及并发症。主要指标疗效、眼表症状评分及并发症。结果术后3个月,观察组与对照组的治愈率分别为98.0%和85.7%(P=0.008)。两组术后3个月的眼表症状评分分别为(18.00±4.22)分和(23.88±3.91)分,都明显低于术前(P=0.000,0.013),同时观察组的眼表症状评分也明显低于对照组(P=0.018)。术后3个月,观察组假道形成、泪小点裂伤、肉芽肿形成、鼻腔出血等并发症发生率为4.1%,而对照组为18.4%(P=0.010)。结论联合泪道置管术的泪道钻通术治疗慢性泪囊炎能提高治愈率,并减少术后并发症,能促进改善眼表症状。

Objective To investigate the curative effects of lacrimal duct drill combined with lacrimal duct intubation on the chronic dacryocystitis. Design Retrospective case series. Participants 98 chronic dacryocystitis cases in Affiliated Hospital of Hainan Medical University from June 2015 to February 2017. Methods 98 cases were divided into observation group and control group with 49 cases in each group accorded to the random draw envelope principle. The control group was given lacrimal duct drill, the observation group was treated with lacrimal duct drill combined with the lacrimal duct intubation. Curative effect, ocular surface changes score and complications were recorded and compared between the two groups. The follow-up duration was 3 months. Main Outcome Measures curative effect, ocular surface changes score and complications. Results After 3 months, the cure rate of the observation group and the control group was 98% and 85.7%, respectively （P=0.008）. The ocular surface change scores at postoperative 3 months in the observation group and the control group was 18.00±4.22 and 23.88±3.91 respectively, which were significantly lower than that of preoperation（P=0.000, 0.013）, and the score in the observation group was significantly lower than that in the control group （P=0.018）. The complication （lacrimal laceration, granulation formation, nasal bleeding） rate was 4.1% in the observation group, 18.4% in the control group（P=0.010）. Conclusion Combined with lacrimal intubation, lacrimal duct drill can improve the cure rate and reduce the incidence of postoperative complications for the chronic dacryocystitis patients, which can also improve ocular symptoms.