双泪小管式人工泪管置入术治疗化疗后继发泪道阻塞的手术时机与疗效

Analysis of the effectiveness and surgical timing for the treatment of lacrimal duct obstruction secondary to chemotherapy by bicanalicular stent intubation

目的:探讨双泪小管式人工泪管置入术治疗化疗后继发泪道阻塞的手术时机与疗效。方法:回顾性分析我院2015-07/2018-04因化疗继发泪道阻塞行双泪小管式人工泪管置入术患者50例100眼,按手术日距首次化疗开始日时间分为3组,第1组≤180d(24眼),第2组>180~<360d(36眼),第3组≥360d(40眼)。术后所有患者至少随访12mo,记录术后疗效。结果:术后12mo判定疗效,第1组、第2组、第3组患者手术有效率分别为83.3%、61.1%和30.0%,随着手术干预时间的推迟,手术有效率明显降低(χ~2=18.322,P<0.01)。结论:恶性肿瘤患者接受5-氟尿嘧啶(5-FU)、替吉奥(S-1)或多烯紫杉醇药物化疗后所继发的泪道阻塞,早期诊断和手术干预,对提高手术成功率有明确意义。

·AIM:To evaluate the effectiveness and surgical timing for the treatment of lacrimal duct obstruction secondary to chemotherapy by bicanalicular stent intubation.·METHODS:A retrospective analysis was performed on50 patients of 100 eyes who underwent bicanalicular stent intubation from July 2015 to April 2018 in our hospital,all the patients were suffered from lacrimal duct obstruction secondary to chemotherapy.They were divided into three groups according to the length of time between the date of surgery and the date of first chemotherapy.All patients were followed for at least 12 mo post-operation.Ophthalmic physical examinations and lacrimal duct irrigations were recorded.·RESULTS:Evaluating the effectiveness 12 mo after surgery.The efficiency of group 1,group 2 and group 3 were 83.3%,61.1%,30.0%,respectively.With the delay of surgical intervention,the efficiency decreased significantly,and the difference was statistically significant(χ~2=18.322,P<0.01).·CONCLUSION:Early diagnosis and surgical intervention of lacrimal duct obstruction secondary to chemotherapy with 5-FU,S-1 or docetaxel in patients with malignant tumors are of great significance to improve the success rate of surgery.