CAJ | 학술논문

目的评价泪道激光吻合口成形,联合U形泪道扩张管用于泪囊鼻腔吻合术后复发病例的临床效果.方法回顾性对比分析2008年1月至2012年1月间在解放军第四七四医院全军眼科中心就诊的41例(41只眼)泪囊鼻腔吻合术后复发病例.其中,采用泪道激光吻合口成形联合U形泪道扩张管植入术治疗17例为观察组;采用二次泪囊鼻腔吻合术24例为对照组.评价标准:观察组术后3个月拔管,拔管后2个月复查;对照组术后2个月复查,流泪症状消失并冲洗泪道通畅为治愈;流泪但冲洗泪道不全堵塞为好转;流泪并冲洗泪道完全堵塞为失败;治愈和好转合计为有效.采用SPSS 11.0统计软件进行数据处理分析,对组间治愈率和有效率比较行彭检验.结果观察组治愈12例(70.59％,12/17),好转2例(11.76％,2/17),计有效14例(82.35％,14/17);失败3例(17.65％,3/17).对照组治愈9例(37.50％,9/24),好转8例(33.33％,8/24),计有效17例(70.83％,17/24);失败7例(29.17％,7/24).两组间治愈率差异比较有统计学意义(x2=4.3606,P=0.039);两组间有效率差异比较无统计学意义(x2=0.2276,P=0.43).结论泪道激光吻合口成形联合U形泪道扩张管植入术用于泪囊鼻腔吻合术后失败病例,可以取得满意效果.对比二次泪囊鼻腔吻合术,具有操作简便、损伤小、安全性好、患者痛苦小、治愈率高的优点,值得临床进一步研究应用.
목적 평개루도격광문합구성형,연합U형루도확장관용우루낭비강문합술후복발병례적림상효과.방법 회고성대비분석2008년1월지2012년1월간재해방군제사칠사의원전군안과중심취진적41례(41지안)루낭비강문합술후복발병례.기중,채용루도격광문합구성형연합U형루도확장관식입술치료17례위관찰조;채용이차루낭비강문합술24례위대조조.평개표준:관찰조술후3개월발관,발관후2개월복사;대조조술후2개월복사,류루증상소실병충세루도통창위치유;류루단충세루도불전도새위호전;류루병충세루도완전도새위실패;치유화호전합계위유효.채용SPSS 11.0통계연건진행수거처리분석,대조간치유솔화유효솔비교행팽검험.결과 관찰조치유12례(70.59％,12/17),호전2례(11.76％,2/17),계유효14례(82.35％,14/17);실패3례(17.65％,3/17).대조조치유9례(37.50％,9/24),호전8례(33.33％,8/24),계유효17례(70.83％,17/24);실패7례(29.17％,7/24).량조간치유솔차이비교유통계학의의(x2=4.3606,P=0.039);량조간유효솔차이비교무통계학의의(x2=0.2276,P=0.43).결론 루도격광문합구성형연합U형루도확장관식입술용우루낭비강문합술후실패병례,가이취득만의효과.대비이차루낭비강문합술,구유조작간편、손상소、안전성호、환자통고소、치유솔고적우점,치득림상진일보연구응용.
Objective To explore the clinical effectiveness of laser-assisted artificial nasolacrimal duct implantation in the anastomois recanalization to treating recurrent dacryocystitis.Methods The clinical data of 41cases (41 patients) with recurrent dacryocystitis were retrospective analyzed,17 cases treating with laser-assisted artificial nasolacrimal duct implantation to recanalizing the anastomois,which was the observation group,24 cases treating with second traditional dacryocystorhinostomy,which was control group.All cases were diagnosed recurrent dacryocystitis after first dacryocystorhinostomy from 3 to 25 months.Evaluation standard:observation cases were followed up for 2months after pull out the duct,which had been remained 3 month; control cases were followed up 2 months after operation.Cure standard was no tear running and no obstruction of lacrimal duct,improved standard was tear running and obstruction of lacrimal duct,invalid standard was tear running and obstruction of lacrimal duct,effective standard was cured or improved.Results In the observation group,12 cases were cured 70.59％,2 improved 11.76％,3 invalided; effective rate was 82.35％,invalid rate was 17.65％.In the control group,9 cases were cured,8 cases were improved,7 cases were invalided,cure rate was 37.50％,improved rate was 33.33％,effective rate was 70.83％,and invalid rate was 29.17％.The cure rate in the observation group was significantly great than that in the control group (x2 4.3606,P 0.039),the effective rate between the observation group and the control group had no statistical significances (x2 0.2276,P 0.43).Conclusions The laser-assisted artificial nasolacrimal duct implantation can be used to treat postoperative recurrence of dacryocystorhinostomy with good result,compared with second dacryocystorhinotomy,it is a safe,simple and effective way with high cure rate.The laser-assisted artificial nasolacrimal duct implantation is worth studying and popularizing.