全泪道置管下泪道灌洗术对泪道阻塞性疾病患者眼表症状及复发率的影响研究

Study on the Effect of Lacrimal Duct Lavage under Total Lacrimal Duct Catheterization on Ocular Surface Symptoms and Recurrence Rate in Patients with Lacrimal Duct Obstruction

目的:研究全泪道置管下泪道灌洗术对泪道阻塞性疾病患者眼表症状及复发率的影响.方法:选取本院2017年5月-2019年5月收治的泪道阻塞性疾病患者50例62眼,根据治疗方法不同将其分为对照组24例31眼和观察组26例31眼.对照组给予传统泪道置管术治疗,观察组给予全泪道置管下泪道灌洗术治疗.对比两组术后临床疗效、眼表症状评分、眼表疾病指数量表(OSDI)评分及各参数评分、术中出血量、住院时间及复发率、并发症发生率.结果:术后,对照组临床总有效率80.65%,明显低于观察组96.77%(P<0.05);术后,两组患者眼部症状总分均低于术前,且观察组明显低于对照组(P<0.05);术后,两组患者OSDI总评分及眼部不适发生频率评分、对日常活动影响评分、不良环境的眼部不适发生频率评分均明显低于术前,且观察组均低于对照组(P<0.05);观察组术中出血量少于对照组,住院时间短于对照组(P<0.05);观察组的并发症发生率与复发率均低于对照组(P<0.05).结论:全泪道置管下泪道灌洗术治疗泪道阻塞性疾病,可有效提高患者的治疗效果,改善眼部症状,降低并发症及再次手术的风险,值得临床推广应用.

Objective:To study the effect of lacrimal duct lavage under whole lacrimal duct catheterization on ocular surface symptoms and recurrence rate in patients with lacrimal duct obstruction.Method:From May 2017 to May 2019,50 patients 62 eyes with lacrimal duct obstruction were selected,according to different treatment methods,they were randomly divided into control group(24 cases,31 eyes)and observation group(26 cases,31 eyes).The control group was treated with traditional lacrimal duct catheterization,the observation group was treated with whole lacrimal duct catheterization and lavage.The clinical effect,ocular surface symptom score,ocular surface disease index(OSDI)score,parameters score,intraoperative hemorrhage,length of stay,recurrence rate and complication rate were compared between the two groups.Result:After surgery,the total clinical response rate of the control group was 80.65%,which was significantly lower than 96.77%of the observation group(P<0.05).After surgery,the total score of ocular symptoms in both groups was lower than that before surgery,and the observation group was significantly lower than that of the control group(P<0.05).After surgery,the OSDI total score,the influence score on daily activities,eye discomfort frequency score,and eye discomfort frequency score of adverse environment in both groups were significantly lower than those before surgery,and the observation group were lower than those of the control group(P<0.05).The amount of intraoperative blood loss in the observation group was less than that in the control group,and the length of hospital stay was shorter than that in the control group(P<0.05).The complication rate and recurrence rate of the observation group were lower than those of the control group(P<0.05).Conclusion:The treatment of lacrimal duct obstruction by total lacrimal duct lavage can effectively improve the therapeutic effect of patients with lacrimal duct obstruction,improve ocular symptoms,reduce the risk of complications and reoperation,and is worthy of clinical application.