天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (1): 74-78.doi: 10.11958/20202113

• 临床研究 • 上一篇    下一篇

泪道扩张引流管与一次性使用泪道引流管在泪道不同部位阻塞治疗中的价值#br#

张蕾，杨丽红，潘叶，翟文娟，孙春华，赵红△   

  1. 天津市眼科医院眼眶整形科，天津市眼科学与视觉科学重点实验室，南开大学附属眼科医院，天津医科大学眼科临床学院，天津市眼科研究所（邮编300020）
  • 收稿日期:2020-07-24 修回日期:2020-09-03 出版日期:2021-01-15 发布日期:2021-01-15
  • 通讯作者: 张蕾 E-mail:380502025@qq.com

Comparison of two different artificial lacrimal tubes intubated after lacrimal duct laser in the treatment of lacrimal drainage system obstruction

ZHANG Lei, YANG Li-hong, PAN Ye, ZHAI Wen-juan, SUN Chun-hua, ZHAO Hong△   

  1. Department of Orbital and Oculoplastic Surgery Department, Tianjin Eye Hospital, Tianjin 300020, China; Tianjin Key Lab of Ophthalmology and Visual Science; Nankai University Affiliated Eye Hospital; Clinical College of Ophthalmology, 
    Tianjin Medical University; Tianjin Eye Institute
  • Received:2020-07-24 Revised:2020-09-03 Published:2021-01-15 Online:2021-01-15
  • Contact: 赵红 E-mail:380502025@qq.com

PDF (PC)

308

摘要： 摘要：目的　分析比较泪道扩张引流管（简称扩张管）与一次性使用泪道引流管（简称引流管）在泪道阻塞中的疗效及各自适应证。方法　回顾性分析2013年1月—2019年9月在天津市眼科医院行掺钕钇铝石榴石（Nd: YAG）激光治疗联合泪道置管的317例患者（354眼），其中男103例（111眼），女214例（243眼），年龄20～84岁，平均（47.4±15.6）岁。按照阻塞部位不同分为单纯鼻泪管阻塞组（单纯组）及复杂泪道阻塞组（复杂组）。每组按照置入人工泪管类型不同又各分为扩张管组与引流管组2个亚组。其中单纯组159眼（扩张管107眼、引流管52眼），复杂组195眼（扩张管98眼、引流管97眼）。结果　单纯组和复杂组中扩张管和引流管亚组患者之间性别、年龄、病程及Munk分级比较差异均无统计学意义（P＞0.05）。单纯组扩张管治愈率为88.79%、有效率为95.33%，高于引流管治愈率71.15%、有效率82.69%（χ2分别为7.716、5.473，P＜0.05）。复杂组扩张管治愈率31.63%，有效率56.12%，低于引流管治愈率51.55%、有效率71.13%（χ2分别为7.961、4.745，P＜0.05）。单纯组与复杂组扩张管的鼻根酸胀发生率明显高于引流管（P＜0.05）。结论　Nd: YAG激光泪道成形术联合泪道置管可有效治疗泪道阻塞，扩张管更适宜于鼻泪管单一部位阻塞，而引流管更适宜于含鼻泪管阻塞的多个部位的复杂性泪道阻塞。

关键词: 泪器阻塞；导管, 留置；激光疗法；激光, 固体；泪道扩张引流管；泪道引流管；激光泪道成形术；泪道再通

Abstract: Abstract: Objective　To analyze and compare the results of lacrimal dilation tubes and lacrimal drainage tubes in the treatment of lacrimal drainage system obstruction, and further clarify their indications. Methods　Data of 317 patients included 354 eyes with lacrimal duct obstruction underwent lacrimal duct laser and implantation of lacrimal artificial tubes in Tianjin Eye Hospital from January 2013 to September 2019 were retrospectively analyzed. In all patients, 103 patients (111 eyes) were male, 214 patients (243 eyes) were female, and the mean age was (47.4±15.6，range, 20-84) years. According to the different obstruction sites, the patients were divided into simple nasolacrimal duct obstruction group (simple group) and complex lacrimal duct obstruction group (complex group). According to the different types of artificial lacrimal duct placement, each group was subdivided into two groups, the dilated duct group and the drainage duct group. There were 159 eyes in the simple group (107 eyes with dilator tube and 52 eyes with drainage tube) and 195 eyes in the complex group (98 eyes with dilator tube and 97 eyes with drainage tube). Results　There were no significant differences in gender, age, course and Munk grade between the two subgroups (P＞0.05). In the simple nasolacrimal duct obstruction group，the cure rate and effective rate of dilation tube (88.79% , 95.33%) were significantly higher than those of drainage tube (71.15%, 82.69%), (χ2=7.716 and 5.473 respectively, P＜0.05). In the complicated lacrimal passage obstruction group, the cure rate and effective rate (51.55%, 71.13%) were significantly higher in drainage tube than those of dilation tube (31.63%, 56.12%) (χ2=7.961 and 4.745 respectively, P＜0.05). The incidence of nasoenoic acid distension was significantly higher in dilated tubes than that in drainage tubes (P＜0.05). Conclusion　Lacrimal duct laser with implantation of artificial lacrimal tubes is efficient for obstruction of lacrimal drainage system obstruction. The dilation tube is more suitable for patients with simple nasolacrimal duct obstruction, while drainage tube is more suitable for patients with complication lacrimal duct obstruction.

Key words: lacrimal duct obstruction, catheters, indwelling, laser therapy, lasers,solid-state, lacrimal dilation tube, lacrimal drainage tube, laser lacryocystoplasty, lacrimal duct recanalizatio