两种手术方法治疗鼻泪管阻塞286例疗效比较

目的:比较传统泪囊鼻腔吻合术和下泪道逆行植入硅胶管术治疗鼻泪管阻塞的临床疗效。方法:286例鼻泪管阻塞患者随机分为两组,分别采用2种手术方式,即传统泪囊鼻腔吻合术组(B组)和下泪道逆行植入硅胶管术(A组),术后随访3~20个月,观察术后1年内及≥1年的疗效。结果:下泪道逆行植入硅胶管术与泪囊鼻腔吻台术术后<1年及≥1年总有效率(91.6%vs 80.4%,93.0%vs81.8%)差异均无统计学意义(P>0.05),下泪道逆行植入硅胶管手术术中、术后并发症少。结论:下泪道逆行植入硅胶管术与泪囊鼻腔吻合术术后疗效及远期疗效相近,且下泪道逆行植入硅胶管术操作简便,手术创伤小,无皮肤切口和瘢痕,是一种安全有效的手术方法,值得临床上推广。

Effects comparison of two surgical approach on 286 nasolacrimal duct obstruction cases

Objective：To compare clinical efficacy of conventional dacryocystorhinostomy and retrograde nasal lacrimal silicone tube implantation on nasolacrimal duct obstruction.Methods：A total of 286 cases of nasal lacrimal duct obstruction were randomly divided into group B and group A,which were treated with conventional dacryocystorhinostomy and retrograde nasal lacrimal silicone tube implantation,respectively.Follow up ranging from 2-20 months were conducted on all patients to observe the clinical effects 1 year or ≥ 1 year after they underwent the operation.Results：The total efficacy within 1 year and ≥ 1 year after they underwent the operation of group A vs group B were 91.6% vs 80.4% and 93.0% vs 81.8%（P0.05）,but less complications occurred in group A during or after the operation.Conclusions：Though both instant and long-term efficacy of conventional dacryocystorhinostomy and retrograde nasal lacrimal silicone tube implantation are similar,the later one is easier,minimally invasive and safer,which is worth for application in large scale.