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.     

泪道激光联合引流管植入治疗泪道阻塞的临床观察

目的 研究泪道激光联合引流管植入对泪道阻塞患者眼表状态的影响。 方法 选取2014年1月~2015年12月收治的120例泪道阻塞患者,采用数字奇偶法随机分为对照组和观察组,每组60例,其中对照组行常规手术治疗,观察组行泪道激光联合引流管植入术。分析观察组术前、术后1个月及术后2个月的泪膜破裂时间和泪液分泌量。 结果 对照组治疗总有效率为75.0%低于观察组约91.7%(P<0.05);观察组各个时间段的泪膜破裂时间比较差异无统计学意义(P>0.05);术后2个月患者的泪液分泌量较治疗前差异无统计学意义(P>0.05);术后1个月泪液分泌量较治疗前上升,差异有统计学意义(P<0.05)。 结论 泪道激光联合引流管植入治疗泪道阻塞患者,可取得较好的治疗效果,且对患者眼表状态无明显影响。     

泪道阻塞部位分析及治疗方法的选择

泪道阻塞是一类常见眼病,阻塞部位可作为潜在感染病灶,易致角膜溃疡及眼部手术感染.手术治疗效果可靠,但损伤大,操作复杂,颜面部易遗留瘢痕.泪道插管是近年应用的新技术.德州市人民医院眼科2001年8月至2007年5月应用不同的插管方法治疗泪道各部位阻塞引起的泪道疾病,取得了较好效果.     

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。     

改良泪道探通术注入素高捷疗眼膏治疗泪道阻塞的临床观察

目的探讨改良泪道探通术注入素高捷疗眼膏治疗泪道阻塞的临床效果.方法 用7～9号腰脊穿刺针针头去尖,磨光后制成改良空管式泪道探针.为慢性泪囊炎98例、102眼探通泪道后沿空管注入素高捷疗眼膏,使之布满泪道内壁,尽快修复探通的泪道内皮,达到扩张疏通的目的.以同一疾病84例、85眼为对照组,以1～3号银质泪道扩张针扩通泪道,留针15min,隔日1次,共扩张2～3次,扩张后用 0.25%氯氟液冲洗.结果术后随访3个月,观察组治愈率为97.05%,对照组治愈率为9.41%,差异有高度显著性(P<0.01).结论用改良的泪道探针探通泪道后注入素高捷疗眼膏,促使泪道修复,是治疗泪道阻塞或狭窄的有效方法.     

支撑喉镜下喉硅胶膜置入及声带缝合手术治疗喉蹼

目的探讨喉硅胶膜置入及声带黏膜缝合术在治疗喉蹼中的价值及预后转归。方法21例喉蹼患者，4例儿童，17例成人；其中既往有双侧声带手术史（声带任克水肿、声带小结、声带息肉、声带角化）8例，喉乳头状瘤手术史6例，喉部外伤史6例，先天性喉蹼1例。患者在全麻支撑喉镜下行喉蹼瘢痕松解后，15例成人行声带黏膜缝合及喉硅胶膜置入术；4例儿童及2例成人行单纯声带黏膜缝合术。结果15例喉硅胶膜置入患者3—4周后取出支撑的硅胶膜，除1例既往曾有喉裂开史，治疗后前联合处仍残留2—3mm粘连带外，其余14例患者声带前联合均获得良好三角形形态，发音明显改善，无呼吸困难。6例行单纯声带黏膜缝合患者呼吸及发音得到明显改善，2例成年患者前联合处残存2～3mm正常黏膜，术后声带即获得很好成形效果；4例患儿术后前联合残留2—3mm粘连。全部患者随诊6个月-3年，无瘢痕再生。结论喉硅胶膜置入及声带缝合手术治疗喉蹼，利于患者呼吸及发音功能的改善，避免颈外入路手术或气管切开及长期声门支撑，创伤小，并发症少。而声带黏膜单纯缝合手术还可以单独应用于粘连带相对较薄（小于5mm）、黏膜相对丰富的儿童及前联合残存正常黏膜的喉蹼患者。     

泪道穿线联合插管治疗泪道阻塞慢性泪囊炎的临床研究

目的探讨治疗泪道阻塞和慢性泪囊炎简便有效的方法.方法用泪道穿线联合插管治疗泪道阻塞25眼,泪囊炎28眼.结果痊愈44例、48眼,占90.57%;有效5例、5眼,占9.43%.结论泪道穿线联合插管治疗泪道阻塞,泪囊炎成功率高,患者损伤轻,痛苦小,适于推广.     

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。     

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。     

Flexible Nd:YAG laser palliation of obstructive tracheal metastatic malignancies.

Flexible Nd:YAG endoscopic laser surgery may become an effective new modality for palliation in patients with obstructive endotracheal metastatic malignancies. We report the results of the treatment of two patients with severely obstructing intraluminal tracheal metastatic melanoma and medullary thyroid carcinoma, using the neodymium-YAG laser via the flexible fiberoptic bronchoscope. Both patients complained of significant dyspnea, orthopnea, cough, and hemoptysis and were not candidates for rigid bronchoscopy because of underlying medical contraindications and anatomical problems. Multiple treatment sessions were used with treatment intervals of 1 to 2 weeks. All treatments were performed in the operating room under sedation, without intubation, with topical lidocaine and standard superior laryngeal nerve block. Successful relief of airway obstruction with complete regression of the endotracheal masses was achieved and no recurrences were seen after 9 months' follow-up. Flexible Nd:YAG laser bronchoscopy offered an alternative for the relief of obstructing endotracheal or bronchial malignancies in patients in whom the rigid bronchoscope could not be passed. it seemed to prolong survival in selected cases, and provided definite improvement in quality of life.     

激光治疗阻塞性睡眠呼吸暂停低通气综合征疗效评价

目的：探讨Nd：YAG激光治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法：对89例OSAHS患者行激光悬雍垂腭咽成形术(LAUP)．手术切除部分软腭及悬雍垂，在悬雍垂两侧向上楔形打开软腭。结果：术后6个月复查有76例行多导睡眠监测，治愈8例，显效36例，有效25例，无效7例，总有效率90．8％。结论：Nd：YAG激光具有止血凝固作用且穿透力强，手术视野清晰，并发症少，可缩短手术时间。LAUP治疗OSAHS效果良好。     

Use of the Nd:YAG laser in otorhinolaryngology]

The Nd:YAG laser is suitable for the treatment of various otorhinolaryngological clinical disorders. These include the palliative reduction of tumor size in sites with difficult access, treatment of hemangiomas and reduction of hyperplastic turbinates. Within certain limits, other indications are treatment of recurrent epistaxis and recurrent polyposis. Palliative reduction of malignancies in the nasopharynx, esophagus, and bronchial system (laser power density: 1500-8000 W/cm2) must sometimes be carried out in several sessions in order to avoid complications due to the laser (i.e., perforation of the bronchial or esophageal wall, lesions of adjacent vessels or nerves). Nd:YAG laser treatment of hemangiomas (500-3000 W/cm2) can lead to excellent results. To avoid excessive thermal lesions, vascular tissue is cooled with ice cubes or with an ice-cold Ringer's solution. The laser process is continued until the onset of tissue blanching. Carbonizations of the tissue are to be avoided. In Nd:YAG laser therapy of hyperplastic lower nasal conchae (approx. 1000 W/cm2), results are based on submucous scarring in which the covering epithelium is maintained. The objective of Nd:YAG laser treatment of recurrent epistaxis in patients with Osler's disease (500 W/cm2) is to reduce the incidence of hemorrhage. Use of the laser in recurrent polyposis is best confined to patients who refuse conventional surgical revision operations. Laser light (500-3500 W/cm2) should only be applied for a short period of time (0.5 s) to avoid creating a rarefying osteitis.     

Management of traumatic dacryocystitis and failed dacryocystorhinostomy using silicone lacrimal intubation set

The aim of this work is to study the management and success rate of traumatic dacryocystitis and failed dacryocystorhinostomy (DCR) using Silicone lacrimal intubation set. A prospective study was conducted at a tertiary eye care hospital, India from February 2006 to January 2008. This study material comprised 50 patients of traumatic dacryocystitis and failed dacryocystorhinostomy. Anterior single flap external dacryocystorhinostomy with Silicon intubation was performed in all the patients. The patients were followed up at weekly intervals for 1?month and thereafter every 2?months for 1?year post operatively. Criteria determining success were based on resolution of epiphora and patency on syringing. In traumatic dacryocystitis, 21(91.3%) cases fulfilled these criteria while 23(85.2%) cases of failed DCR were successful. The overall success rate (88%) was determined with an average follow-up of 1?year. Globally, the technique was effective in 85% of cases. The results were comparable with other similar studies. This study concludes that performing a DCR in traumatic dacryocystitis and failed DCR taking into consideration the complications and chances of failure is a challenge for the surgeon. We opine that External dacryocystorhinostomy with Silicon Intubation is one of the most effective modality in dealing with such cases.     

鼻内窥镜下应用Nd:YAG激光治疗鼻深部出血

目的探讨鼻内窥镜下治疗鼻深部出血的临床效果.方法鼻深部出血43例于鼻内窥镜下找到出血点后,用YAG激光治疗,并观察疗效.结果43例中,37例治疗后止血,5例治疗后第1天少许渗血,此后未再出血,1例无效,填塞出血部位后止血,治愈率为97.67%(42/43).随诊3月余,尿毒症1例治疗后半月又出血,再次治疗后未再复发,其余41例无复发.结论在鼻内窥镜下寻找出血点并应用YAG激光治疗,视野清楚,定位准确,治疗方便,创伤及痛苦小,疗效好,是治疗鼻深部出血的有效方法.     

Combined intratumor cisplatinum injection and Nd:YAG laser therapy

OBJECTIVES/HYPOTHESIS: Interstitial laser therapy (ILT) has become useful for tumor palliation in patients with advanced head and neck cancer. Cisplatinum chemotherapy also is a frequent adjuvant treatment for recurrent tumors, but systemic toxicity limits application. Intratumor cisplatinum injection combined with ILT may improve therapy of these recurrent tumors with reduced toxicity. STUDY DESIGN: Prospective. Tumor transplants were injected with cisplatinum in a gel implant before ILT to evaluate treatment response and toxicity in a preclinical study. METHODS: UCLA-P3 human squamous cell carcinoma tumors were grown as subcutaneous transplants in nude mice and treated by intratumor injection of 2 mg/mL cisplatinum in a slow-release, collagen-based gel carrier 4 hours before interstitial implantation of Nd:YAG laser fiberoptics to induce local tumor hyperthermia. Treatment efficacy and toxicity were followed for 12 weeks after combined drug and laser therapy compared with ILT alone. RESULTS: Combined cisplatinum gel and ILT was a significant improvement (P < .01 by chi-square test) and induced 57% complete responses without regrowth in 21 transplanted tumors compared with only 24% in 21 tumors after ILT alone during 12-week follow-up. Recurrences in both cases appeared to result from nonuniform laser energy delivery within tumors via the implanted fiberoptic tip. CONCLUSIONS: The results of this experimental combined cisplatinum and ILT study suggest it may be possible to improve treatment of advanced head and neck cancer by intratumor injection of gel implants containing the drug followed by interstitial Nd:YAG laser hyperthermia.     

Nd: YAG laser treatment for adult hypopharyngeal haemangioma

Adult hypopharyngeal haemangioma is an uncommon neoplasm. We present three cases of adult hypopharyngeal haemangioma which were successfully treated with a neodymium: yttrium-aluminium-garnet (Nd: YAG) laser in our hospital between 2000 and 2003. The patients in this series experienced no untoward events from the use of the laser. Excessive bleeding and airway problems were not encountered. Postoperative pain was minimal. Excellent long-term function and a full resolution of symptoms can be obtained using Nd: YAG laser. The laser provides a bloodless field and complete healing of the hypopharynx, without stenosis or scar formation.