三种不同的术式治疗泪小管炎的临床疗效比较

Comparison of Clinical Efficacy of Three Different Surgical Procedures for Lacrimal Canaliculitis

目的:探讨应用泪小管三角形切开联合取结石,泪点扩张联合泪小管挤压取结石,与泪小管切开取结石联合置入人工泪小管对泪小管炎的临床疗效。方法:本研究为回顾性研究。选取承德医学院附属医院眼科2017年6月到2020年3月行手术治疗泪小管炎的患者31例(31眼),根据手术方式分为A(10眼)、B(12眼)、C(9眼)三组,A组采用三角形切开泪小管管壁治疗泪小管炎;B组采用先扩张泪点、按摩泪小管排除泪小管内结石治疗泪小管炎;C组采用泪小管切开联合置入人工泪小管治疗泪小管炎,比较三组患者术后3个月的结膜炎,泪点炎,泪小管炎及泪小管通畅情况及并发症情况。结果:A组有效率为80.0%(8/10),B组有效率为66.7%(8/12),C组有效率为100.0%(9/9),三组比较差异有统计学意义(P<0.05)。结论:采用泪小管切开联合置入人工泪管治疗泪小管炎手术疗效佳,并发症少,是治疗泪小管炎的一种理想的手术方式。

Objective:To investigate the clinical effects of triangular incision of lacrimal canaliculus combined with calculi removal,punctal dilation combined with lacrimal canaliculus extrusion for calculi removal,and incision of lacrimal canaliculus combined with artificial lacrimal canaliculus placement for lacrimal canaliculitis.Methods:This study was retrospective.A total of 31 patients(31 eyes)with canaliculitis who had surgery in the Affiliated Hospital of Chengde Medical University from June 2017 to March 2020 were selected and divided into group A(10 eyes),group B(12 eyes)and group C(9 eyes)according to surgical methods.Group A was treated with triangular incision of lacrimal canalicular wall for canaliculitis;group B was treated with dilation of tear points and massage of lacrimal canaliculi to rule out lacrimal canalicular calculi;group C was treated with lacrimal canaliculitis by lacrimal canaliculotomy combined with placement of artificial lacrimal canaliculi.Conjunctivitis,punctitis,lacrimal canaliculitis and lacrimal canalicular patency and complications at 3 months after operation were compared among the three groups.Results:The effective rate was 80.0%(8/10)in group A,66.7%(8/12)in group B,and 100.0%(9/9)in group C.There was a significant difference among the three groups(P<0.05).Conclusion:The lacrimal canaliculus incision combined with artificial lacrimal duct placement is an ideal surgical method for the treatment of lacrimal canaliculitis with good curative effect and less complications.