New mucosal flap modification for endonasal endoscopic dacryocystorhinostomy in Asians

AIM: To describe a simple modification of fashioning the mucosal flap for endonasal endoscopic dacryocystorhinostomy (EES-DCR) in Asians and investigate its efficacy. METHODS: A total of 120 patients with unilateral primary chronic dacryocystitis (PCD) were randomized into two groups: the new shaped nasal mucosal flap group (group A) and the removed nasal mucosal flap group (group B). All patients underwent standard EES-DCR. Patients in group A were performed a new shaped nasal mucosal flap covering the bared bone around the opened sac and those in group B was removed the nasal mucosal flap uncovering the bared bone. Patients were followed up for one year. The occurrence of granulation tissue, the proliferation of scar tissue and success rate of EES-DCR was compared. RESULTS: In the present study, complete postoperative data were acquired from 54 patients in group A and from 57 patients in group B. During process of review, the occurrence of granulation tissue was at the ostium margins account for 15% (8/54) in group A and 39% (22/57) in group B (P<0.05). At the one-year review, scar tissue was present in 5 patients in group A compared with 18 in group B (P<0.05). The success rate of EES-DCR was 98% (53/54) in group A and 84% (48/57) in group B (P<0.05). CONCLUSION: The simple modification of fashioning nasal mucosal flap can effectively cover the bared bone around the opened sac and reduce formation of granulation tissue, lessen the risk of scar tissue formation and closure of ostium, thus improve the success rate of EES-DCR in Asians.

Outcomes of revision external dacryocystorhinostomy and nasal intubation by bicanalicular silicone tubing under endonasal endoscopic guidance

AIM: To evaluate the long-term treatment outcomes in patients who underwent revision of external dacryocysto- rhinostomy (DCR) and nasal intubation by bicanalicular silicone tubing (BSTI) under endonasal endoscopic guidance. · METHODS: Data from 28 patients with recurrent dacryocystitis were retrospectively reviewed. Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance was performed in 28 eyes of 28 patients. The patients were evaluated with respect to the reason of recurrence, time to recurrence, time to revision, duration of follow-up and surgical success. · RESULTS: Endoscopic endonasal examination detected an osteotomy-side obstruction by the excessive granulation tissue in 24 patients (86%), nasal septal deviation in three patients (10%) and nasal polyp in one patient (4%). Recurrence occurred after a mean duration of 5.3±3.7 months following the first operation. The mean time between the first DCR operation and the revision DCR was 11.5 ± 9.3 months. After a mean follow-up of 14.9±7.8 months, the rate of anatomic success alone was 85% (24/28); the rate of subjective success was 78% (22/28). · CONCLUSION: Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance can be recommended in patients with recurrent dacryocystitis as a surgical approach that achieves satisfactory objective and subjective success rates.

External Dacryocystorhinostomy: 4 Years’ Experience from CHU-IOTA in Mali

Aim: To analyze the clinical characteristics and the surgical outcomes of external dacryocystorhinostomy (DCR) in patients with nasolacrimal duct obstruction (NLDO). Methods: We retrospectively reviewed the clinical record of 62 patients who underwent external DCR for NLDO between November 2015 and November 2019 at CHU-IOTA in Mali. The preoperative clinical findings and the postoperative outcomes after a minimum follow up of 3 months were analyzed. Results: epiphora, discharges and canthal swelling were main symptoms of the 62 patients (68% women, 32% men), with the mean age of 47 years (10 - 76). Among them, 36 had chronic dacryocystitis, 12 had a traumatic NLDO and 8 followed a septal deviation. The majority (77%) were operated on under local anesthesia with sedation. Bicanalicular intubation was performed in 29% of patients. After postoperative follow up of at least 3 months, only 8 patients had persistent watering, thus a subjective functional success of 87%. Conclusion: In the nasolacrimal duct obstruction, most often secondary to chronic dacryocystitis, external dacryocystorhinostomy remains a technique of choice with very good success.

Impact of the interval after endoscopic dacryocystorhinostomy on the outcomes of intraocular surgery: a 4-year retrospective study

Background:Patients with dacryocystitis should be treated for their infection by endoscopic dacryocystorhinostomy(EN-DCR)before any intraocular surgery.However,there is no unified standard for the specific time interval between the two surgeries.This study aimed to determine the appropriate interval for intraocular surgery in patients with previous EN-DCR for chronic dacryocystitis.Methods:The medical files of all patients who underwent intraocular surgery after EN-DCR surgery in our hospital from 2016 to 2019 were reviewed.The EN-DCR data of patients undergoing intraocular surgery at different time intervals and the incidence of endophthalmitis after intraocular surgery were compared.Results:A total of 116 patients(92 females and 24 males,mean age 64.06±7.78 years)underwent EN-DCR and intraocular surgery met the inclusion criteria.The interval between EN-DCR and intraocular surgery varied from 5-475 days.The number of patients undergoing cataract surgery after EN-DCR is the largest(75,64.7%).All patients(100%)who had previously undergone EN-DCR did not develop endophthalmitis infection after intraocular surgery at a follow-up of 12 months.Conclusions:For patients with dacryocystitis who have undergone EN-DCR surgery,there is no time limit when choosing the timing of intraocular surgery.For patients requiring intraocular surgery,operation can be arranged as soon as possible to solve their problems as long as the patients had patency on lacrimal passage irrigation and no secretions.

Surgical outcomes in acute dacryocystitis patients undergoing endonasal endoscopic dacryocystorhinostomy with or without silicone tube intubation

AIM:To establish the necessity of silicone tube intubation in acute dacryocystitis(AD)patients undergoing endonasal endoscopic dacryocystorhinostomy(En-DCR).METHODS:Patients presenting with unilateral AD were randomly assigned to two treatment groups.En-DCR procedures were performed following lacrimal abscess formation,with the operation being performed with silicone intubation for patients in group B but not group A.Functional success was defined by an absence of additional AD episodes,no epiphora,and ostium patency as established via endoscopic evaluation or fluorescein irrigation.Operative success rates and demographic variables were compared between treatment groups.RESULTS:In total,66 patients were analyzed in the present study(33 per group),with complete postoperative data having been successfully collected from 27 and 22 patients in group A and group B,respectively.All patients exhibited complete resolution of acute inflammation.Upon follow-up,granulation tissue was detected around the ostium at higher rates in group B(9/22,40.9%)relative to group A(4/27,14.8%).At the 12-month follow-up time point,patients in group A exhibited higher success rates(25/27,92.6%)relative to patients in group B(20/22,90.9%),but this difference was not significant.Cases of lacrimal passage reconstruction failure in both groups were attributed to excessive fibrous and/or granulation tissue formation proximal to the intranasal ostium.CONCLUSION:Given that these two operative approaches are associated with similar rates of operative success and in light of differences in granulation tissue formation,cost,and operative duration,these data do not support the routine silicone intubation of AD patients following En-DCR surgery.

Comparison of scanning electron microscopy findings regarding biofilm colonization with microbiological results in nasolacrimal stents for external, endoscopic and transcanalicular dacryocystorhinostomy

AIM:To compare bacterial biofilm colonization in lacrimal stents following external dacryocystorhinostomy(EX-DCR),endoscopic dacryocystorhinostomy(EN-DCR),and transcanalicular dacryocystorhinostomy(TC-DCR)with multidiode laser.METHODS:This prospective study included 30consecutive patients with nasolacrimal duct obstruction who underwent EXT-,EN-,or TC-DCR.Thirty removed lacrimal stent fragments and conjunctival samples were cultured.The lacrimal stent biofilms were examined by scanning electron microscopy(SEM).RESULTS:Eleven(36.7%)of the 30 lacrimal stent cultures were positive for aerobic bacteria(most commonly Staphylococcus epidermidis and Pseudomonas aeruginosa).However anaerobic bacteria and fungi were not identified in the lacrimal stent cultures.Twenty-seven(90%)patients had biofilmpositive lacrimal stents.The conjunctival culture positivity after the DCR,biofilm positivity on stents,the grade of biofilm colonization,and the presence of mucus and coccoid and rod-shaped organisms did not significantly differ between any of the groups(P】0.05).However,a significant difference was found when the SEM results were compared to the results of the lacrimal stent and conjunctival cultures(P【0.001).CONCLUSION:Type of dacryocystorhinostomy(DCR)surgery did not affect the biofilm colonization of the lacrimal stents.SEM also appears to be more precise than microbiological culture for evaluating the presence of biofilms on lacrimal stents.

Primary non hodgkin's lymphoma of lacrimal sac presented as recurrent acute dacryocystitis: A case report

Primary non Hodgkin's lymphoma of the lacrimal sac is uncommon but potentially delay in diagnosis as it may mimic the presentation of primary post saccal nasolacrimal duct obstruction. In this article, we reported a case of primary non Hodgkin's lymphoma of the lacrimal sac presented with recurrent acute dacryocystitis in a young lady. A 28 years old Malay lady had history of persistent epiphora on left eye for 4 years. Prior to presentation to our clinic, it was preceded by progressive recurrent painful medial canthal swelling for 6 months duration. Clinical diagnosis of post saccal naso lacrimal duct obstruction was made and otorhinolaryngology assessment revealed intranasal mass. Endoscopic excision was done showed diffuse large B cell lymphoma on histology. The patient was started on 6 cycles of chemotherapy which subsequently result in no recurrence of the tumour post chemotherapy. Any case of post saccal nasolacrimal duct obstruction should be investigated thoroughly as it may become as a presentation of other sinister pathology.

Spherical Headed Silicone Intubation in the Treatment of 26 Cases (31 eyes) of Chronic Dacryocystitis under Nasal Endoscopy

Purpose:To observe the clinical efficacy of spherical headed silicone implantation in the treatment of chronic dacryocystitis under nasal endoscopy.Methods:Twenty-six patients (31 eyes) with chronic dacryocystitis were subjected to spherical headed silicone implantation under topical anesthesia (lacrimal passage and nasal mucosal surface).Lacrimal passage irrigation was performed daily throughout the first postoperative week,and once each month thereafter.Results:All spherical headed silicone tube placements were successfully performed.The operative time ranged from 6 to 11 minutes.Symptoms of epiphora were immediately ameliorated post-operatively,and irrigation demonstrated patency of the lacrimal system in all patients.All patients were followed from 7 to 24 months,during which symptoms of tearing were improved.The lacrimal ducts of 27 eyes (87.7%) were normal.The lacrimal ducts of 4 others.(12.3%).were still blocked.Lacrimal passage irrigation was open and secretion disappeared in 28 eyes(90.3%).Tearing was observed in 3 eyes (9.68%).Conclusion:Spherical headed silicone tube implantation under nasal endoscopy is successful in relieving symptoms of tearing.

Endonasal Endoscopic Dacryocystorhinostomy with the Use of Radiofrequency (RF) Surgical Technique

Endonazal endoscopic dacryocystorhinostomy (DCR) with radiofrequency (RF) surgical technique is a procedure selected for nasolacrimal duct obstruction and chronic dacryostenosis in the setting of patent canaliculi and a functional lacrimal pump. Two major approaches are utilized: external, via a transcutaneous incision and endonasal endoscopically guided. The surgery has the high success rate via both approaches. We review the history, evolution, current techniques, complications and future directions of DCR radiofrequency RF operative technique. The modified endonasal RF-coagulation technique was performed in patients aged 18 - 85 (women-80, men-35) from 2017 to 2023. All patients suffered from chronic dacryocystitis. They had been administered the course of traditional conservative treatment and were provided with the ophthalmologist’s and otorhinolaryngology’s consultations prior to the surgery. In order to verify the diagnosis, the patients were conducted the CT-scan examination of nasal cavity and paranasal sinuses as well as the endoscopy of nasal cavity. Endonasal dacryocystorhinostomy with RF coagulator proved to be effective in 80% of patients;Over 3 - 4 years following the surgery, the recurrence was manifested in 8 patients after 6 months and in 12 patients, after a year. The above mentioned surgical treatment is administered by minimally invasive surgical method. At the same time, the long-term, for about 1 year, implantation of silicone drainage in the nasolacrimal ducts significantly reduces the risk of recurrence. At the present stage, the endoscopic Endo-DCR surgery is being improved, and the diverse treatment methods, including radiofrequency (RF) in endonasal endoscopic microsurgical techniques, are being studied and introduced into practice.

Endoscopic dacryocystorhinostomy in acute dacryocystitis:a multicenter study in China

AIM:To repor t the clinical profile,endoscopic dacryocystorhinostomy(En-DCR)management,and acute dacryocystitis(AD)outcomes in China.METHODS:Clinical data of 554 adult AD patients(554 eyes)who presented in 7 tertiary eye care centers for 10y from Jan 2010 to Mar 2020 were retrospectively analyzed.Clinical profile,En-DCR management,and outcomes of all cases were recorded.The anatomical and functional success were evaluated for 12mo post-operation.RESULTS:The analysis included 149 males and 368 females with a median age of 55.2y(range:18-84y).There were 459 eyes with a history of epiphora or purulent secretion.The time between a symptom of lacrimal duct obstruction and acute onset was 1 to 540(66.1±58.2)mo.Fifty-nine eyes had a history of the previous acute attack.Seventy-four eyes developed a cutaneous fistula,while 11 eyes had post septal cellulitis pre-operation.En-DCR with an anatomical success of 91.7%and functional success of 90.1%.The success rate of the patients with a history of acute episodes and the preoperative fistula was lower than the overall success rates.CONCLUSION:En-DCR can be performed during an acute episode in AD with a success rate of over 90%.

Treatment of acute dacryocystitis by translacrimal canalicular drainage and D-silicone intubation

AIM:To demonstrate the outcomes of translacrimal canalicular drainage using a lacrimal probe and intranasal drainage by D-silicone intubation for acute dacryocystitis(AD).METHODS:This retrospective study included 23 patients with AD and had undergone abscess decompression with the use of lacrimal probe and intranasal drainage by D-silicone intubation between January 2019 and December 2022.Patients received abscess decompression and systemic antibiotic-corticosteroid from the time of diagnosis.D-silicone tube was inserted within 10d after diagnosis and removed 3-6mo after intubation.The procedure and outcomes of this method were evaluated.RESULTS:All patients showed improvement of signs and symptoms of AD within 72h.No intraoperative and postoperative complications were observed.No recurrence of lacrimal sac abscesses occurred after D-silicone tube removed.CONCLUSION:Lacrimal probe and D-silicone intubation appear to be a feasible,minimally invasive,safe,and effective method,which could be a reasonable choice in the treatment of AD.

布地奈德联合鼻内镜手术治疗慢性泪囊炎

目的探讨布地奈德鼻喷雾剂联合鼻内镜手术治疗慢性泪囊炎的效果。方法将慢性泪囊炎患者80例(80眼)纳入前瞻性单盲研究,随机分为布地奈德组(40例)和对照组(40例)。所有患者均接受鼻内镜下鼻腔泪囊吻合术。布地奈德组应用布地奈德鼻喷雾剂喷鼻3个月,对照组应用生理性海水喷鼻3个月。比较2组手术疗效、Lund-Kenndey评分和并发症发生情况。结果随访6个月时,布地奈德组疗效优于对照组(P<0.05)。术后3个月时,2组Lund-Kenndey评分低于术前,布地奈德组Lund-Kenndey评分低于对照组(P<0.05)。布地奈德组并发症发生率低于对照组(5%vs.20%,P<0.05)。结论鼻内镜下鼻腔泪囊吻合术后应用布地奈德鼻喷剂治疗慢性泪囊炎安全有效,手术成功率更高、术后出现吻合口粘连、肉芽肿的概率更小,且不增加术后感染的风险。

单眼慢性泪囊炎患者鼻中隔偏曲的情况观察

目的基于泪道电子计算机断层扫描(CT)造影观察单眼慢性泪囊炎患者鼻中隔偏曲情况。方法纳入2019年7月—2021年2月于成都中医药大学附属医院眼科就诊的单眼慢性泪囊炎患者181例。所有患者入院后均进行泪道CT造影检查,观察鼻中隔偏曲情况,并测量泪囊顶部与底部到鼻中隔的垂直距离。结果(1)鼻中隔偏曲情况:有140例(77.35%)患者存在鼻中隔偏曲,其中鼻中隔偏向患侧的有113例(80.71%),鼻中隔偏向健侧的有27例(19.29%)。(2)泪囊顶部与底部到鼻中隔的垂直距离分析:患侧泪囊顶部到鼻中隔的平均垂直距离低于健侧泪囊顶部到鼻中隔的平均垂直距离,差异有统计学意义(t=-9.293,P=0.000);患侧泪囊底部到鼻中隔的平均垂直距离低于健侧泪囊底部到鼻中隔的平均垂直距离,差异有统计学意义(t=-9.238,P=0.000)。结论本研究发现单眼慢性泪囊炎多见于中老年女性患者,多伴有鼻中隔偏曲,且患侧泪囊到鼻中隔的垂直距离小于健侧泪囊到鼻中隔的距离。

新型鼻腔泪囊吻合术联合丙酸氟替卡松治疗慢性泪囊炎

目的:探讨新型鼻腔泪囊吻合术联合丙酸氟替卡松治疗慢性泪囊炎患者的疗效。方法:前瞻性研究。选择2021-01/2022-12我院收治的慢性泪囊炎患者100例100眼,依据患者入院顺序编号分为对照组50眼(行新型鼻腔泪囊吻合术治疗)和观察组50眼(行新型鼻腔泪囊吻合术联合丙酸氟替卡松治疗)。比较两组患者手术前后最佳矫正视力(BCVA)、生活质量评分以及复发情况。结果:所有患者均完成术后6 mo随访,观察组患者术后总有效率优于对照组(98%vs 84%,P=0.001),手术前后BCVA比较无差异(P>0.05)。术前两组患者生活质量评分比较无差异(P>0.05),术后6 mo,对照组患者的躯体功能、心理功能、社会功能和物质生活状态评分均比观察组低(均P<0.001)。术后6 mo,对照组复发9眼(18%),观察组复发1眼(2%),两组比较有差异(χ^(2)=-2.739,P=0.001)。结论:新型鼻腔泪囊吻合术联合丙酸氟替卡松治疗慢性泪囊炎患者效果佳,可以提高患者的生活质量,降低复发率。

慢性泪囊炎微生物分布及其耐药性

目的了解慢性泪囊炎微生物分布及其耐药性,为临床经验性用药提供参考。方法收集2022年6月—2023年6月西安市第一医院104例慢性泪囊炎患者泪囊分泌物样本。采用自动化微生物鉴定药敏仪进行菌株鉴定。分别采用仪器法和纸片扩散法进行体外药物敏感性试验,分析2种方法的一致性。结果慢性泪囊炎患者细菌培养阳性率为74.04%(77/104),共分离出109株细菌,其中革兰阳性菌75株(68.81%)、革兰阴性菌23株(21.10%)、厌氧菌10株(9.17%)、真菌1株(0.92%)。葡萄球菌对莫西沙星、利福平和万古霉素的敏感率分别为80.00%、97.50%和100.00%。耐甲氧西林葡萄球菌(MRS)对抗菌药物的耐药率明显高于甲氧西林敏感葡萄球菌(MSS);MRS和MSS对左氧氟沙星和克林霉素的耐药率差异有统计学意义(P<0.05)。仪器法与纸片扩散法药物敏感性试验一致性较好(Kappa值为0.832,P<0.05)。结论葡萄球菌是慢性泪囊炎的主要致病菌,莫西沙星、利福平和万古霉素可作为治疗慢性泪囊炎的首选抗菌药物。

Computed tomography for guidance in the diagnosis and surgical correction of recurrent pediatric acute dacryocystitis

Importance:This is the first retrospective study of the effect of computed tomography(CT)in diagnosis and surgical correction of recurrent pediatric acute dacryocystitis(PAD).Objective:To explore the pathogenesis of recurrent PAD and the impact of CT in guidance of surgical planning.Methods:Medical histories,clinical manifestations,and CT results of 10 patients with recurrent PAD were reviewed.Etiologies and treatment effectiveness were recorded for all patients.results:CT revealed that three patients had congenital dacryocystocele with lacrimal sac cyst,enlargement of the nasolacrimal canal,and intranasal cyst of affected sides.After regression of local inflammation,marsupialization was performed.CT showed that four patients had PAD secondary to congenital nasolacrimal canal dysplasia;these patients exhibited normal upper portions of the nasolacrimal canals,but had stenotic or atretic middle and terminal segments.After improvement of local inflammation,endonasal dacryocystorhinostomy was performed.Three patients had PAD secondary to congenital lacrimal sac diverticulum;after contrast injection,CT showed that the cysts at the lacrimal sac area were filled with contrast,and were connected to the normal lacrimal sac.After the topical infection was controlled,transcutaneous dacryocystorhinostomy was performed in combination with excision of the lacrimal sac diverticulum.No recurrence of PAD was detected at 6-month follow-up.Interpretation:Causes of PAD include congenital dacryocystocele,congenital lacrimal sac diverticulum,or congenital nasolacrimal canal dysplasia.Marsupialization with endoscope,endonasal dacryocystorhinostomy,and transcutaneous dacryocystorhinostomy constitute distinct surgeries for PAD treatment.CT provides an important diagnostic function and facilitates selection of specific surgical approaches for recurrent PAD.

慢性泪囊炎相关角膜溃疡的临床特征及治疗转归

目的分析慢性泪囊炎相关角膜溃疡的临床特征及治疗转归,为临床合理诊疗提供依据。方法采用系列病例观察研究方法,纳入2016年1月至2020年1月于山东第一医科大学附属眼科医院诊断为慢性泪囊炎相关角膜溃疡患者31例31眼,平均年龄(53.0±10.8)岁。随访观察眼部临床特征、病原微生物检查及药物敏感试验、治疗及转归。结果患者慢性泪囊炎病史平均(3.6±1.9)年,角膜溃疡多位于角膜周边部,形态呈圆形,边界清晰。角膜刮片培养阳性率为74.2%(23/31),19眼查见细菌,3眼查见真菌菌丝,1眼同时查见革兰阳性球菌及真菌菌丝。微生物培养阳性率为74.2%(23/31),20眼细菌培养阳性(革兰阳性球菌16眼,革兰阴性杆菌4眼),3眼真菌培养阳性。革兰染色阳性球菌对万古霉素、利福平、莫西沙星、左氧氟沙星敏感率分别为100%(16/16)、87.5%(14/16)、81.3%(13/16)、75.0%(12/16)。所有患者均通过手术治疗慢性泪囊炎,其中22眼行鼻内镜下泪囊鼻腔造口吻合术,7眼行泪囊摘除术,2眼行泪道探通联合置管术。角膜溃疡深度<1/3角膜厚度(CT)者9眼,其中6眼经药物治疗(10.8±3.2)d后溃疡愈合,3眼行角膜病损切除术;溃疡深度为1/3~2/3 CT者6眼,均行结膜瓣遮盖术;溃疡深度>2/3 CT者16眼,其中6眼行板层角膜移植术,8眼行穿透性角膜移植术,2眼合并感染性眼内炎行眼内容物剜除术。结论慢性泪囊炎相关角膜溃疡多位于角膜周边部,以革兰阳性球菌感染最为常见。轻症患者应用敏感抗生素治疗后角膜溃疡逐渐愈合,感染严重的患者需要根据角膜溃疡的深度选择合适的手术进行治疗。

缝线吻合技术在鼻内镜下泪囊鼻腔吻合术中的应用

目的探讨鼻内镜下泪囊鼻腔吻合术(En-DCR)中应用缝线吻合技术治疗慢性泪囊炎的效果。方法回顾性分析该院79例(79眼)慢性泪囊炎患者的临床资料,分为缝合组和无缝合组。无缝合组给予En-DCR瓣膜单纯明胶海绵固定技术,缝合组给予En-DCR瓣膜缝线吻合技术。比较两组患者的临床总有效率、术后并发症发生率、吻合口修复时间和肉芽增生等情况。结果术后两组患者总有效率比较,差异无统计学意义(χ^(2)=4.36,P=0.137),并发症总发生率比较,差异无统计学意义(P=0.705)。缝合组造口黏膜上皮愈合时间短于无缝合组,差异有统计学意义(t=0.57,P=0.032),造口肉芽增生少于无缝合组,差异有统计学意义(P=0.037)。结论瓣膜缝线吻合并未改善其临床有效性和安全性,但可缩短造口黏膜上皮愈合时间,减少组织肉芽增生。

鱼腥草滴眼液联合泪道探通术治疗泪道阻塞合并慢性泪囊炎患儿的效果

目的评估鱼腥草滴眼液联合泪道探通术对泪道阻塞合并慢性泪囊炎患儿的治疗效果。方法选择河北省保定市妇幼保健院2021年8月至2022年8月收治的196例泪道阻塞合并慢性泪囊炎患儿为研究对象,采用随机数字表法将患儿分为对照组和观察组,每组98例。对照组给予泪道探通术,观察组采用泪道探通术联合鱼腥草滴眼液冲洗。记录两组患儿的临床疗效,比较两组患儿治疗前和治疗3个月后的炎症因子水平、泪液分泌量、泪膜破裂时间、泪河高度、角膜荧光素染色(FLS)评分、睑板腺分泌状态,比较两组患儿出血、组织水肿、眼膜划伤等并发症发生率和家属满意度。结果观察组患儿的临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗前,两组患儿炎症水平和眼部症状比较,差异无统计学意义(P>0.05)。治疗后,两组患儿炎症因子水平、FLS评分、眼睑板状态评分、泪液分泌量、泪河高度低于治疗前,且观察组低于对照组;两组患儿泪膜破裂时间长于治疗前,且观察组长于对照组,差异有统计学意义(P<0.05)。观察组患儿术后并发症发生率低于对照组,家属满意度优于对照组,差异有统计学意义(P<0.05)。结论泪道探通术联合鱼腥草滴眼液冲洗,能够降低患儿术后炎症因子水平、改善眼部症状,从而提高治疗效果。

两种不同治疗方法治疗婴幼儿泪囊炎的疗效对比分析

目的比较泪道探通术+鱼腥草滴眼液与泪道探通术+妥布霉素滴眼液冲洗治疗婴幼儿泪囊炎的疗效。方法将2021年8月至2022年8月在保定市妇幼保健院接受治疗的200例患有泪囊炎的2个月~2岁婴幼儿纳入本次前瞻性研究。按照随机数字表法将其分为鱼腥草组(n=100)和妥布霉素组(n=100)。鱼腥草组患儿接受泪道X线造影+鱼腥草滴眼液冲洗+泪道探通术治疗;妥布霉素组患儿接受泪道X线造影+妥布霉素滴眼液冲洗+泪道探通术治疗。比较两组的临床疗效、1次探通成功率、治疗前后血清炎症因子[白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)和高敏C反应蛋白(hs-CRP)]水平、并发症发生情况及术后复发情况。结果鱼腥草组和妥布霉素组的总有效率比较(90.00%vs.95.00%),差异无统计学意义(P>0.05)。鱼腥草组与妥布霉素组的1次探通成功率比较(91.00%vs.96.00%),差异无统计学意义(P>0.05)。治疗后,两组的血清IL-6、TNF-α和hs-CRP水平均较治疗前显著下降,差异均有统计学意义(P<0.05);鱼腥草组与妥布霉素组治疗后的血清IL-6、TNF-α和hs-CRP水平比较[(2.52±0.71)pg/mL vs.(2.39±0.65)pg/mL,(5.18±1.61)pg/mL vs.(5.05±1.57)pg/mL,(10.57±2.46)mg/L vs.(10.10±2.27)mg/L],差异均无统计学意义(P>0.05)。鱼腥草组与妥布霉素组的并发症发生率(7.00%vs.4.00%)和术后复发率(0 vs.0)比较,差异均无统计学意义(P>0.05)。结论鱼腥草滴眼液冲洗+泪道探通术治疗婴幼儿泪囊炎的临床疗效与妥布霉素滴眼液冲洗+泪道探通术相当,且安全性高,术后不易复发。