激光泪道成形术联合抗代谢药物治疗泪道阻塞临床分析

Clinical analysis of laser lacrimal ductoplasty combined with anti-metabolic drugs in the treatment of lacrimal passage obstruction

目的分析激光泪道成形术联合抗代谢药物治疗泪道阻塞的临床疗效。方法选取2015年7月～2017年2月在本院接受治疗的72例泪道阻塞患者作为研究对象，有84只眼（有鼻泪管阻塞眼23只，慢性泪囊炎眼16只，泪小管阻塞眼45只），所有患者均接受激光累到成形术联合抗代谢药物治疗，术后对泪道进行冲洗，并对患者进行为期3个月的随访，分析本组患者的临床治疗情况与并发症情况。结果接受手术治疗3个月后，71只眼治愈，构成比为84.52%；10只眼好转，构成比为11.90%；3只眼治疗失败，构成比为3.57%。本组患者中有1例在神经阻滞麻醉时发生眼眶周血肿，对症治疗恢复正常后1周接受手术，并发症发生率为1.19%。结论应用激光泪道成形术联合抗代谢药物对泪道阻塞进行治疗，具有手术操作简单，疗效显著且并发症率低的优点，具有临床推广应用价值，但应严格控制丝裂霉素的应用剂量，术后对泪道进行冲洗，并做好抗菌预防，以降低并发症发生率，提高临床治疗效果。

Objective To analyze the laser lacryocystoplasty combined with antimetabolites in the treatment of lacrimal duct obstructionclinical curative effect.Methods72cases of lacrimal duct from July2015to February2017in our hospital for treatment of COPD patients as theresearch object,84eyes(23eyes with nasolacrimal duct obstruction and chronic dacryocystitis16eyes in tears tubular obstruction and45eyes).Allpatients underwent laser angioplasty combined with tired to anti metabolic drug treatment,postoperative flushing of lacrimal duct,and for a period of3months of follow-up of patients,analysis of clinical treatment in this group of patients with complications of surgery.Results After3months oftreatment,71eyes were cured,accounting for84.52%;10eyes were better,accounting for11.90%;3eyes of treatment failure,accounting for3.57%.patients in this group had1cases of orbital hematoma in nerve block anesthesia,symptomatic treatment returned to normal1weeks after surgery,the complication rate was1.19%.Conclusion The application of laser lacryocystoplasty combined with anti drug metabolism of lacrimal ductobstruction were treated with simple operation,obvious curative effect and low complication rate advantages,has the value of clinical application,butshould strictly control the application of Dose Mitomycin,postoperative flushing of lacrimal duct,and good antibacterial prophylaxis,and to reducethe The incidence of the disease and the effect of clinical treatment.