CAJ | 학술논문

目的：比较两种高频泪道浚通联合术在基层不同患者群、不同病期应用的疗效，同时分析影响疗效的主要相关问题。方法随机把95例(155只眼)患有泪道阻塞的患者，分为无管组47例(73只眼)和义管组48例(82只眼)。两组均施行高频泪道浚通术，无管组联合贝复舒(重组牛碱性成纤维生长因子)滴眼液留置；义管组联合硅胶义管植入。慢性泪囊炎患者行病原微生物检测。术后均泪道冲洗，观察两组患者的治疗效果。随访9~12个月。结果无管组73只眼，炎症期38只眼、治愈23只眼、好转6只眼，总有效率为76.3%；稳定期35只眼、治愈26只眼、好转2只眼，总有效率80.0%。义管组82只眼，炎症期42只眼、治愈37只眼、好转3只眼，总有效率为95.2%；稳定期40只眼、治愈37只眼、好转2只眼，总有效率为97.5%。炎症期和稳定期两组疗效比较，其差异均具有统计学意义(P<0.05)。结论高频泪道浚通联合硅胶义管植入术治疗多种泪道阻塞可取得良好的疗效。掌握术中的操作要点，术前、术中、术后的泪道冲洗和微生物学分析是手术成功的关键。
목적：비교량충고빈루도준통연합술재기층불동환자군、불동병기응용적료효，동시분석영향료효적주요상관문제。방법수궤파95례(155지안)환유루도조새적환자，분위무관조47례(73지안)화의관조48례(82지안)。량조균시행고빈루도준통술，무관조연합패복서(중조우감성성섬유생장인자)적안액류치；의관조연합규효의관식입。만성루낭염환자행병원미생물검측。술후균루도충세，관찰량조환자적치료효과。수방9~12개월。결과무관조73지안，염증기38지안、치유23지안、호전6지안，총유효솔위76.3%；은정기35지안、치유26지안、호전2지안，총유효솔80.0%。의관조82지안，염증기42지안、치유37지안、호전3지안，총유효솔위95.2%；은정기40지안、치유37지안、호전2지안，총유효솔위97.5%。염증기화은정기량조료효비교，기차이균구유통계학의의(P<0.05)。결론고빈루도준통연합규효의관식입술치료다충루도조새가취득량호적료효。장악술중적조작요점，술전、술중、술후적루도충세화미생물학분석시수술성공적관건。
Objective To compare the therapeutic effects of two kinds of high-frequent electrolacryocysto-plasty joint operations at the grass-roots level in different groups of patients at different stage of illness, and to analyze the main related problems affecting the curative effect. Methods Totally 95 patients (155 eyes) with lachrymal duct obstruction diseases were randomly divided into no-pipe group (47 patients, 73 eyes) and pipe group (48 patients, 82 eyes). The two groups both received high-frequent electrolacryocystoplasty joint operation. The patients of no-pipe group were treated with injecting bFGF (basic fibroblast growth factor), and the patients of pipe group were treated with silicone intubation. Patients with chronic dacryocystitis were detected with pathogenic microorganisms. After op-eration, all the patients were treated by duct flushing. Treatment results of two groups were followed up for 9~12 months. The curative effect was observed. Results In the no-pipe group (73 eyes), of the 38 eyes in inflammation stage, 23 were cured and 6 were improved, with the effective rate of 76.3%. Of the 35 eyes in stable stage, 26 were cured and 2 were improved, with the effective rate of 80.0%. In the pipe group (82 eyes), of the 42 eyes in inflammation stage, 37 were cured and 3 were improved, with the effective rate of 95.2%. Of the 40 eyes in stable stage, 37 were cured and 2 were improved, with the effective rate of 97.5%. There were statistically significant differences between the two groups in the clinical efficacy in both inflammation stage and stable stage (P<0.05). Conclusion High-fre-quent electrolacryocystoplasty combined with silicone intubation is more effective on lachrymal passage obstruction. Before, in and after the operation, grasping the key points of operation, lachrymal duct flushing, and microbiological analysis play important roles for the success of the operation.