泪道激光成型联合硅胶管植入术治疗泪道阻塞

目的探讨泪道激光成型联合硅胶管植入术治疗泪道阻塞的效果。 方法对泪道阻塞患者９０例（９４眼）行泪道激光成型联合硅胶管植入术,保留硅胶管３～６个月,术后随访,观察泪道引流泪液功能的恢复情况。结果拔管后随访半年以上,治愈８4眼（８9．３6％）,好转８眼（８．５１％）,总有效率９7．８7％。结论泪道激光成型联合硅胶管植入术治疗泪道阻塞是一种有效的治疗方法。     

激光手术对泪道阻塞临床治疗效果及不良事件发生率探讨

目的 探究激光手术对泪道阻塞的临床治疗效果并观察患者的不良事件发生情况。方法 对2021年3月～2022年3月期间在本院治疗泪道阻塞的50例患者进行回顾研究,将采取泪道探通联合置管术的25例患者纳入对照组,将加行激光手术的25例患者纳入研究组。评估两组治疗效果、观察复发率、不良事件发生情况并进行对比。结果 就总有效率而言,研究组(96%)高于对照组(72%),统计学对比有差异(X²=5.357,P=0.021<0.05)。就复发率而言,研究组(0%)低于对照组(16%),统计学对比有差异(X²=4.348,P=0.037<0.05)。就不良事件发生率而言,研究组(4%)接近对照组(12%),统计学对比无差异(X²=1.087,P=0.297>0.05)。结论 激光手术治疗泪道阻塞疗效显著、不良事件少、复发率低,临床价值显著。     

Nd：YAG激光泪道疏通及圆锥形硅胶棒植入治疗泪道阻塞

目的评价NdYAG激光泪道疏通并圆锥形硅胶棒植入治疗阻塞性泪道疾病的疗效。方法82例、91眼泪道阻塞及泪囊炎激光泪道疏通后植入硅胶棒。结果泪道阻塞27眼,泪囊炎64眼。阻塞部位依次为鼻泪管68眼,泪总管31眼;泪小管21眼。1处及2处阻塞各35眼,3处以上21眼。首次硅胶棒留置时间12～180d,平均41.74d,一次性治愈68眼,好转5眼,无效18眼,有效率80.22%,14眼经二次硅胶棒植入,最终治愈78眼,好转5眼,无效8眼,总有效率91.21%。18眼19次复发,复发率20.88%。16眼泪点撕裂,是最常见的并发症。结论该方法安全简便,疗效及可重复性好。     

鼻内窥镜下激光泪囊鼻腔造孔术治疗泪道阻塞

报告鼻内窥镜下以激光行泪囊鼻腔造孔术，治疗２５例（２８眼）泪道阻塞患者。资料显示，该手术操作简单，可在门诊进行；术中出血甚少反应轻；避免面部切口，不损伤内眦韧带；术后可保留泪囊的唧筒排泪作用；治愈率高，表明该术式治疗慢性泪囊炎较之泪囊鼻腔吻合术更具优越优越性。     

KTP激光在治疗泪道阻塞中的应用

目的评价KTP激光治疗泪道阻塞的效果.方法对32例泪道阻塞患者先用泪小点扩张器扩张泪小点,再用带针芯的探针探通阻塞部位,然后抽出针芯,用KTP激光治疗.结果32例经一次治疗均获得成功,并取得了良好的生理功能.结论KTP激光治疗泪道阻塞相对手术治疗有许多优点,而且治疗率高,患者痛苦少,易于接受,是治疗泪道阻塞的最佳方法.     

微小切口泪小管切开联合置入RS泪道引流管治疗泪小管炎48例

目的 探讨微小切口泪小管切开联合置入RS泪道引流管治疗泪小管炎48例的临床疗效.方法 病例对照研究,选取泪小管炎患者92例(92眼)入组.48例(48眼)行微小切口泪小管切开联合置入RS泪道引流管作为研究组,44例(44眼)行常规泪小管切开联合置入环形泪道引流管作为对照组.对两组术中暴露泪小管管腔的时间、置管的时间、置...     

第五代泪道内镜微钻疏通联合人工鼻泪管置入治疗鼻泪管阻塞的临床观察

目的 探讨第五代泪道内窥镜下泪道疏通联合人工鼻泪管置入治疗鼻泪管阻塞的临床疗效。 方法 选取2014年1月至2015年12月诊治的61例(61眼)鼻泪管阻塞患者为研究对象,采用泪道内窥镜下微钻疏通联合人工鼻泪管置入术治疗。 结果 随访观察6个月,治愈48例(48眼),好转8例(8眼),有效率91.8%,无效5例(5眼)。 结论 第五代泪道内窥镜下微钻疏通联合人工鼻泪管植入治疗鼻泪管阻塞安全、有效,创伤小,并发症少。     

经鼻泪道扩张联合丝裂霉素C治疗鼻泪管阻塞

目的 评价经鼻泪道扩张联合丝裂霉素Ｃ（MMC）治疗鼻泪管阻塞的疗效和临床应用价值。方法 将60例鼻泪管阻塞患者随机分为丝裂霉素组(A组)和硅胶管组（B组）,经鼻泪道扩张后A组局部使用MMC,B组逆行置入硅胶管,随访6个月,观察治疗成功率。结果 经鼻泪道扩张联合MMC与逆行置入硅胶管术的疗效差异无统计学意义（Ｐ＝０.058）。结论 经鼻泪道扩张联合MMC治疗鼻泪管阻塞可取得与逆行置入硅胶管术相似的临床疗效,具有操作简便、费用低廉、治疗时间短、创伤小、恢复快等优点。     

泪道置管手术治疗鼻泪管阻塞的临床应用效果

目的 探讨鼻泪管阻塞患者治疗中,选择泪道置管手术的价值。方法 筛选71例鼻泪管阻塞患者作为样本,71例样本选取时间为2019年1月～2022年1月,做随机分组处理后,按1:1比例分组,对照组35例样本给予传统泪道探通术治疗,观察组36例样本给予泪道置管手术,对比2组临床疗效、并发症率、临床指标。结果 观察组临床疗效（88.89%）测定结果,较对照组（62.86%）呈升高趋势（P<0.05）;观察组并发症率（5.56%）测定结果,较对照组（20.00%）呈降低趋势（P<0.05）;观察组OSDI评分、泪河高度测定结果,较对照组呈下降趋势;脂质层评级测定结果,较对照组呈升高趋势（P<0.05）。结论 将泪道置管手术应用在鼻泪管阻塞治疗过程中,既可提升整体疗效及预后效果,亦可降低泪河高度及干眼症状评分,值得借鉴及参考。     

Results of endoscopic assisted probing for congenital nasolacrimal duct obstruction in older children

PURPOSE: To evaluate the results of lacrimal probing with the use of nasal endoscopy and identify the anatomical anomalies responsible for the symptoms in older children. METHODS: Fifty-two eyes of 40 children with congenital nasolacrimal duct obstruction underwent primary probing of the lacrimal duct under general anaesthetic in conjunction with nasal endoscopy. Patients followed up for at least 6 months. Cure was defined as complete resolution of symptoms or minimal symptoms brought on by cold or wind. RESULTS: The age range was 12-126 months. In 30/52 (57.7%) eyes the symptoms were attributed to a single mechanical obstruction. Seven eyes had canalicular stenosis. Three eyes had upper nasolacrimal duct obstruction. Nine eyes had narrow duct and nine eyes had atresia of the distal end of the duct. Two eyes had only intranasal abnormalities. In 16/52 (30.76%) eyes a combination of anomalies was responsible for the symptoms. Nine eyes had canalicular stenosis in association with: either a membrane at the valve of Hasner in four, or a narrow duct in three, or intranasal anomalies in two. Two eyes had punctual stenosis and narrow duct. Two eyes had narrow duct and tight inferior turbinate. Three eyes had abnormal openings in association with stenotic ducts. Six (11.54%) eyes had functional blockage. With the use of endonasal endoscopy, intranasal anomalies identified in 12 eyes and treated in nine. One eye had large inferior conchae. One eye had inferior concha adherent to lateral nasal wall. One eye had redundant nasal mucosa. Three eyes had tight inferior turbinate. Three had abnormal openings. In three eyes the probe went submucosally. The overall success rate was 84.6% (44/52 eyes). Eight eyes remained unchanged. Endoscopically treated cases contributed to the overall success by 17.31%. CONCLUSION: Multiple anatomical anomalies within the lacrimal system and abnormalities of the nose are quite common in older children. Lacrimal probing remains the primary treatment and nasal endoscopy is a useful adjunct to probing increasing the success rate of the procedure.     

Comparison of two endoscopically assisted procedures in primary surgical treatment of congenital nasolacrimal duct obstruction in children older than 3 years: balloon dilatation and bicanalicular silicone tube intubation

OBJECTIVES: To determine the success of two transnasally endoscopic assisted procedures as balloon dilatation and bicanalicular silicone tube intubation for the primary surgical treatment of congenital nasolacrimal duct obstruction in children older than 3 years. STUDY DESIGN: Prospective randomized clinical trial. METHODS: An interventional case series of consecutive primary endoscopic assisted balloon dilatation (BD) and bicanalicular silicone tube intubation (STI) for congenital nasolacrimal duct obstruction in children older than 3 years was reviewed. BD was performed in 20 eyes of 17 patients and STI was performed 24 eyes of 20 patients. Clinical success was defined as a complete remission of epiphora at the end of follow-up period of 12 months and a continuation of the remission at least for 4 months. RESULTS: Eighteen out of 20 eyes (90%) nasolacrimal ducts responded to BD whereas the rate was 15 out of 24 eyes (62.5%) in STI group. No significant complications occured in BD group while the complication rate in STI group was 8 out of 24 eyes (33.3%). chi(2)-Statistical analysis showed significantly better results for BD in clinical success and complication rates than those of STI. CONCLUSIONS: BD should be the first choice therapy instead of invasive approaches with high rate of complications and lower success rates such as silicone intubation, in patients who are older than 3 years.     

可降解型VisiPlug泪道塞栓治疗准分子激光原位角膜磨镶术后干眼疗效观察

目的 评估可降解型VisiPlug泪道塞栓治疗准分子激光原位角膜磨镶术后干眼的临床效果及安全性。 方法 将2009年7月至2013年12月就诊拟行准分子激光原位角膜磨镶术(Laser Assisted In-situ KeratomiLeusis,LASIK)且术前伴有轻到中度干眼的患者65例(130眼)纳入研究,手术完成后于当日行术眼下泪小点可降解型VisiPlug泪道塞栓植入。记录患者术前,术后1周、1个月及3个月干涩感、异物感、烧灼感、畏光感、视疲劳及视力模糊6项症状评分,并于各时间点对患者进行基础泪液分泌试验(Schirmer I test,SIt)、泪膜破裂时间(break-up time,BUT)以及角膜荧光素染色(fluorescein staining,FS)检查。 结果 术后各时间点干涩感、异物感、烧灼感、畏光感、视疲劳及视物模糊6项症状评分均有下降,差异有统计学意义(F=125.64、263.16、123.22、9.80、76.815、105.19,P=0.000、0.000、0.000、0.002、0.000、0.000)。术后各时间点SIt值及BUT值均有提高,FS评分均有下降,差异有统计学意义(F=45.99、67.87、49.01,P=0.000、0.000、0.000)。全部受试者在观察时间内均未发生感染、塞栓溢出或丢失、局部肉芽肿形成等泪道塞栓植入等情况。 结论 应用可降解型VisiPlug泪道塞栓可安全、有效地增加准分子激光原位角膜磨镶术后患者眼表泪液量,改善泪膜稳定性,缓解干眼症状。     

鼻内镜下上颌骨内侧壁切除联合经鼻腔泪道置管治疗上颌窦内翻性乳头状瘤

目的 探讨鼻内镜下上颌骨内侧壁切除联合经鼻泪道置管,在上颌窦内翻性乳头状瘤手术中的应用价值。方法 回顾分析2006年1月至2010年10月采用鼻内镜下上颌骨内侧壁切除联合经鼻泪道置管治疗32例上颌窦内翻性乳头状瘤患者的临床资料。术中切除上颌骨内侧壁,彻底切除上颌窦肿瘤,经鼻泪道置入硅胶管,术后长期随访。结果 32例患者均为Krouse分期T₃期,全部彻底切除肿瘤,术后随访12~72个月,平均35个月,术腔上皮化良好,2例复发,复发率为6.3%,局部清除后随访未再复发,患者均无溢泪并发症。结论 鼻内镜下上颌骨内侧壁切除是治疗Krouse分期T₃期上颌窦内翻性乳头状瘤的良好术式,术中联合经鼻泪道置管可以预防泪道狭窄。     

咽鼓管球囊扩张联合鼓膜切开置管对慢性复发性分泌性中耳炎疗效的Meta分析

目的 系统评价咽鼓管球囊扩张联合鼓膜切开置管对慢性复发性分泌性中耳炎的治疗效果.方法 在万方,中国知网(CNKI),维普(VIP),中国生物医学文献(CBM),PubMed,Web of science,Cochrane library等中外文数据库中检索自建库以来至2020年3月有关咽鼓管球囊扩张治疗慢性复发性分泌性...     

Contact laser turbinate surgery for the treatment of idiopathic rhinitis

To evaluate the value of contact laser turbinate surgery using a diode laser in the treatment of idiopathic rhinitis, 53 patients were examined before and after surgery. Six months following surgery, nasal obstruction was significantly improved and a significant decrease in nasal airway resistance was noted on active rhinomanometric measurements (P < 0.05). There were no significant post-operative changes in olfactory acuity using the butanol threshold test and in mucociliary transport using the saccharin transit time. The results of this study suggest that contact laser turbinate surgery may be a valuable alternative form of surgical treatments for patients with idiopathic rhinitis.     

穿刺抽液加石膏模压迫固定治疗耳廓假性囊肿的疗效观察

目的分析评价耳廓假性囊肿患者采取穿刺抽液加石膏模压迫固定治疗的临床疗效。方法本次将我校附属医院2018年1月—2019年1月收治的60例耳廓假性囊肿患者作为研究的对象,每组平均为30例;其中,对照组患者采取超短波照射理疗方法治疗,观察组患者采取穿刺抽液加石膏模压迫固定治疗,进一步对两组患者的临床治疗效果进行对比、分析评价。结果(1)观察组治疗总有效率为90.00%,与对照组的80.00%比较明显更高,两组之间的数据存在显著统计学差异(P<.05)。(2)随访6个月,观察组复发率为6.67%,与对照组的30.00%比较明显更低,两组之间的数据存在显著统计学差异(P<0.05)。结论在临床中,针对耳廓假性囊肿患者,采取穿刺抽液加石膏模压迫固定治疗效果显著,随访复发率低;因此,值得推广及应用。