中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
Chinese Journal of ocular trauma and occupational eye disease
2015年
10期
725-731
,共7页
泪器疾病%泪道再造术%移植%大隐静脉%口唇粘膜%随访%远期
淚器疾病%淚道再造術%移植%大隱靜脈%口脣粘膜%隨訪%遠期
루기질병%루도재조술%이식%대은정맥%구진점막%수방%원기
Reconstruction,lacrimal passage%Transplantation%Vein,saphenous,great%Mucosa
目的：分析自体组织移植泪道再造术的远期效果与不同的手术方式的关系。方法回顾性分析自体组织移植泪道再造术83例(85只眼)的病历资料。按所行手术方式的不同分为4组，分析患者的临床资料，将疗效分为治愈、好转、无效。用秩和检验的方法分析4组患者的远期效果。结果远期2~6年随访A组(经鼻内窥镜自体大隐静脉移植泪道再造术组)18例(19只眼)，治愈3只眼、好转7只眼、无效9只眼，有效率为52.63%；B组(经鼻内窥镜自体唇黏膜移植组)23例(23只眼)，治愈17只眼、好转4只眼、无效2只眼，有效率为91.30%；C组(经皮肤大隐静脉移植组)14例(14只眼)，治愈2只眼、好转5只眼、无效7只眼，有效率为50.00%；D组(经皮肤唇粘膜移植组)28例(29只眼)，治愈21只眼、好转5只眼、无效3只眼、有效率为89.66%。4组患者远期效果差异性分析(Kruskal-Wallis H test)，差异有统计学意义(P<0.005)。结论自体唇粘膜移植泪道再造术与自体大隐静脉移植泪道再造术比较，前者远期疗效较好并发症较少。
目的：分析自體組織移植淚道再造術的遠期效果與不同的手術方式的關繫。方法迴顧性分析自體組織移植淚道再造術83例(85隻眼)的病歷資料。按所行手術方式的不同分為4組，分析患者的臨床資料，將療效分為治愈、好轉、無效。用秩和檢驗的方法分析4組患者的遠期效果。結果遠期2~6年隨訪A組(經鼻內窺鏡自體大隱靜脈移植淚道再造術組)18例(19隻眼)，治愈3隻眼、好轉7隻眼、無效9隻眼，有效率為52.63%；B組(經鼻內窺鏡自體脣黏膜移植組)23例(23隻眼)，治愈17隻眼、好轉4隻眼、無效2隻眼，有效率為91.30%；C組(經皮膚大隱靜脈移植組)14例(14隻眼)，治愈2隻眼、好轉5隻眼、無效7隻眼，有效率為50.00%；D組(經皮膚脣粘膜移植組)28例(29隻眼)，治愈21隻眼、好轉5隻眼、無效3隻眼、有效率為89.66%。4組患者遠期效果差異性分析(Kruskal-Wallis H test)，差異有統計學意義(P<0.005)。結論自體脣粘膜移植淚道再造術與自體大隱靜脈移植淚道再造術比較，前者遠期療效較好併髮癥較少。
목적：분석자체조직이식루도재조술적원기효과여불동적수술방식적관계。방법회고성분석자체조직이식루도재조술83례(85지안)적병력자료。안소행수술방식적불동분위4조，분석환자적림상자료，장료효분위치유、호전、무효。용질화검험적방법분석4조환자적원기효과。결과원기2~6년수방A조(경비내규경자체대은정맥이식루도재조술조)18례(19지안)，치유3지안、호전7지안、무효9지안，유효솔위52.63%；B조(경비내규경자체진점막이식조)23례(23지안)，치유17지안、호전4지안、무효2지안，유효솔위91.30%；C조(경피부대은정맥이식조)14례(14지안)，치유2지안、호전5지안、무효7지안，유효솔위50.00%；D조(경피부진점막이식조)28례(29지안)，치유21지안、호전5지안、무효3지안、유효솔위89.66%。4조환자원기효과차이성분석(Kruskal-Wallis H test)，차이유통계학의의(P<0.005)。결론자체진점막이식루도재조술여자체대은정맥이식루도재조술비교，전자원기료효교호병발증교소。
Objective To study the relationship between the long-term efficacy of the autogenic tissue transplantation on lacrimal passage reconstruction and various surgical approach. Methods The medical records of 85 eyes of 83 patients who underwent lacrimal passage reconstruction by autogenic tissue transplantation were retrospectively analysed. Patients were divided into 4 groups according to surgical methods. Endonasal dacryocystorhinostomy with great saphenous vein transplantation was done in group A. Endonasal dacryocystorhinostomy with labial mucosa transplantation was done in group B. Transskin conventional dacryocystorhinostomy with great saphenous vein transplantation was done in group C. Transskin conventional dacryocystorhinostomy with labial mucosa transplantation was done in group D. The clinical data were analysed. According to those data,the clinical efficacy was divided into curative, improved and invalid. The difference of long-term efficacy of the four groups were analysed using rank sum test. Results Long-term follow-up was from two to six years. Among the 18 patients (19 eyes ) in group A, 3 eyes were cured, 7 eyes were improved and 9 eyes were invalid. The effective rate was 52. 63%. Among the 23 patients(23 eyes) in group B, 17 eyes were cured, 4 eyes were improved and 2 eyes were invalid. The effective rate was 91. 30%. Among the 14 patients (14 eyes) in group C, 2 eyes were cured, 5 eyes were improved and 7 eyes were invalid. The effective rate was 50. 00%. Among the 28 patients(29 eyes) in group D, 21 eyes were cured, 5 eyes were improved and 3 eyes were invalid. The effective rate was 89. 66%. The differences of long-term efficacy among the four groups (Kruskal-Wallis H test) were statistically significant (P<0. 005). Conclusion Lacrimal passage reconstruction by using labial mucosa transplant is more practical and safe than by using great saphenous vein.
