泪道探通联合氧氟沙星眼膏治疗泪道阻塞及慢性泪囊炎

泪道阻塞和慢性泪囊炎是眼科常见疾病，主要表现为溢泪和粘液脓性分泌物，常给患者带来生活不便，同时它又是一个潜在的感染病灶，容易引起角膜溃疡及眼部手术的感染，目前治疗以冲洗．探通．激光和手术为主，探通冲洗简便易操做，但容易再次阻塞。我院自2003年10月-2005年10月2年中应用泪道探通加氧氟沙星眼膏治疗泪道阻塞及慢性泪囊炎26例（28只眼）疗效满意。     

激光泪道成形术联合典必殊眼膏填充治疗泪道阻塞

目的探讨激光泪道成形术联合应用典必殊眼膏填充泪道治疗泪道阻塞的疗效。方法用Nd:YAG激光泪道治疗机对58例泪道阻塞患者进行泪道成形术联合典必殊眼膏填充泪道,观察疗效;对单纯泪道阻塞和伴有慢性泪囊炎患者的疗效进行比较。结果单纯泪小管阻塞治愈35例,治愈率达89.74%;鼻泪管阻塞治愈10例,2例有效,7例无效,治愈率达52.63%,无效者均为伴有慢性泪囊炎的患者;总治愈率77.59%,其中单纯泪道阻塞者治愈率达91.84%,对伴有慢性泪囊炎者治愈率22.22%。结论激光泪道成形术联合典必殊眼膏填充泪道是治疗单纯泪道阻塞的有效方法。     

激光泪道成形术治疗阻塞性泪道疾病的疗效对比观察

泪道阻塞是一类常见眼病,包括泪小点阻塞、泪小(总)管阻塞、鼻泪管阻塞和慢性泪囊炎及外伤性泪小管离断等。非手术治疗方法简便,但效果差,未从根本上解决泪道阻塞。手术治疗提高了疗效,但损伤大,操作复杂,颜面部遗留疤痕[1],复发率高而不易为患者接受。作者从1999年8月至2001年7月应用ND-YAG激光开展激光泪道成形术治疗各种阻塞性泪道疾病603例693眼,并对疗效进行对比观察,现总结报告如下。1资料与方法1.1临床资料泪小点阻塞15例23眼、泪小(总)管阻塞165例192眼,单纯鼻泪管阻塞206例227眼,慢性泪囊炎197例231眼,外伤性泪小管离段20例20眼,…     

泪道探通术治疗泪道阻塞病人48例体会

目的探讨泪道探通术在治疗泪道阻塞的病人中的护理方法。方法泪小管及泪总管阻塞35例,鼻泪管阻塞6例,慢性泪囊炎7例,均行泪道探通术。结果泪小管阻塞全部治愈,泪总管阻塞治愈率95%,鼻泪管阻塞治愈率98%。结论泪道探通术是治疗泪道阻塞?慢性泪囊炎安全、有效的方法,围手术期应根据不同的时间段采取相应的护理方法。     

复发性泪囊炎鼻腔泪囊解剖学特点及其在内镜下鼻腔泪囊吻合联合支架植入术中的应用

目的 内镜下观察鼻腔泪囊的解剖结构，采用鼻腔泪囊吻合术联合支架植入方式治疗慢性复发性泪囊炎，并观察其疗效。 方法 收集2010年1月至2019年1月期间就诊于甘肃省人民医院耳鼻咽喉头颈外科的已行传统内镜下鼻腔泪囊吻合术后再次复发的慢性泪囊炎患者30例，共计30只眼，予以再次行内镜下鼻腔泪囊吻合术，术中联合支架植入术，术后3个月拔出泪道支架，观察患者术后流泪症状，冲洗泪道判断泪道阻塞情况，随访期为12个月。 结果 随访至12个月时，30例患者14只眼无诉流泪，溢泪，冲洗泪道通畅，鼻内镜下观察见造瘘口通畅，造瘘口无明显缩小；30例12只眼无诉流泪，溢泪，冲洗泪道通畅，但可见造瘘口缩小；4只眼可见造瘘口旁肉芽增生，再次堵塞造瘘口，治疗整体有效率为87%。 结论 内镜下鼻腔泪囊吻合术联合支架植入是治疗慢性复发性泪囊炎一种有效方法，临床效果良好。     

泪道探通术治疗新生儿泪囊炎疗效观察

目的：探讨泪道探通术治疗新生儿泪囊炎的安全性及临床疗效。方法148例(共191眼)患者分为两组,其中A组为6~12个月龄100眼,B组为12~26月龄91眼,行泪道探通术,观察其安全性及临床疗效。结果 A组一次探通成功98眼,治愈率为98%,B组一次探通成功80眼,治愈率为87.9%。 A组与B组比较(字2=7.459,<0.05),差异有统计学意义。结论新生儿泪囊炎在经抗生素眼液滴眼、泪囊按摩及泪道冲洗后无效后,尽量选择在6~12月龄内行泪道探通术,它是一种简便、安全、有效的治疗方法,是基层医院门诊治疗新生儿泪囊炎的一种较好方法。     

激光泪道成形术治疗泪道阻塞的临床观察

目的 观察激光泪道成形术治疗泪道阻塞的效果及复发病例再次激光联合插管治疗的效果。方法 采用Nd：YAG激光泪道成形术治疗泪道阻塞102例。132眼。对复发病例。再次行激光联合插管治疗。结果 113眼一次治愈，有效9眼。术后10眼复发，再次行激光联合插管治疗，7眼治愈，3眼未愈。本组总治愈率90．9％，有效率97．7％。结论 Nd：YAG激光泪道成形术治疗泪道阻塞操作简单，安全有效，复发病例联合插管治疗可以提高治愈率。     

不同疗法治疗新生儿泪囊炎的临床观察

目的 观察不同疗法治疗新生儿泪囊炎的临床疗效.方法 90例(120眼)新生儿泪囊炎患儿依次行泪囊加压按摩、泪道冲洗、泪道冲洗联合探通术.结果 120眼均恢复正常的泪道功能.结论 泪道冲洗探通疗法是治疗新生儿泪囊炎最安全有效的方法.泪囊加压按摩适合于3个月龄以前的患者,泪道冲洗和泪道冲洗联合探通疗法适合于3个月龄以后的患者.同时,患儿家长配合治疗是新生儿泪囊炎治疗成功的关键因素之一.     

泪道探通法治疗婴幼儿泪囊炎的体会

目的探讨泪道探通法治疗婴幼儿泪囊炎泪管闭塞的要点．方法操作者指压挤泪囊部，行加压泪道冲洗法，探针留置10～15min拔出．拔针后再泪道冲洗一次．结果4082例中4000例患儿经泪道探通法治疗泪管闭塞。治愈率98％．结论有效的联合操作泪道探通术，对于治疗婴幼儿泪囊炎的起着重要的康复作用．     

微创改进鼻腔泪囊吻合术治疗高龄慢性泪囊炎30例

目的评价微创技巧改进鼻腔泪囊吻合术的安全性及有效性。方法随机选取30例(30眼)慢性泪囊炎患者,年龄60～82岁,行微创技巧改进的鼻腔泪囊吻合术,术中发现泪囊萎缩无法行鼻腔泪囊吻合术即行泪囊摘除术,术后1周、1个月、3个月、6个月行泪道冲洗。术后随访6个月,观察术后流泪症状、患者满意度以及并发症。结果 29例(29眼)成功行改进的鼻腔泪囊吻合术,1例术中发现泪囊萎缩行泪囊摘除术。术后1周,27例流泪消失或改善,其中24例泪道冲洗通畅,3例泪道冲洗部分通畅,1例下泪小点外翻,泪道冲洗通畅仍流泪。1例术后4 d鼻腔出血,行鼻腔填塞治疗治愈,无其它并发症发生。术后6个月26例(26眼)泪道冲洗通畅,3例(3眼)部分通畅,2例患者流泪无明显改善。结论微创技巧改进的鼻腔泪囊吻合术能减少出血与面部瘢痕、缩短手术时间、节约成本、降低手术风险,对高龄患者安全有效。     

Nd：YAG激光泪道成形术和鼻泪管支架术治疗慢性泪囊炎的疗效对比

目的比较Nd：YAG激光泪道成形术和鼻泪管支架术治疗慢性泪囊炎的临床效果。方法 93例（102眼）慢性泪囊炎患者随机分成两组,一组应用Nd：YAG激光泪道成形术治疗,另一组应用鼻泪管支架术治疗,比较两组的治疗效果。结果应用Nd：YAG激光泪道成形术治疗57眼,有效39眼（68.42%）;鼻泪管支架术治疗45眼,有效40眼（88.89%）,两组疗效差异有统计学意义（χ2=6.03,P〈0.01）。结论鼻泪管支架术相对于同样微创的Nd：YAG激光泪道成形术治疗慢性泪囊炎疗效更加稳定,手术成功率更高,不失为微创治疗慢性泪囊炎的首选术式。     

Nd:YAG激光治疗儿童后发障的临床观察

目的探讨Nd:YAG激光治疗儿童后发障的时机、效果及并发症。方法用Nd:YAG激光对65例87眼儿童后发障患者进行治疗。结果术后视力提高1行者7眼,占8%;提高2行者20眼,占22.9%;提高3行及以上者54眼,占62%;术后视力未提高者6眼,占6.8%。结论Nd:YAG激光治疗儿童后发障是一种安全有效的方法,并应尽早进行。     

Lacrimal Duct Occlusion Is Associated with Infectious Keratitis

Background: To explore the prevalence of lacrimal duct obstruction in patients with infectious keratitis, and the necessity of lacrimal duct dredge in the treatment of human infectious keratitis.Methodology/Principle Findings: The design is prospective, non-control case series. Thirty-one eyes from twenty-eight continuous patients with infectious keratitis were included in this study. The presence/absence of lacrimal duct obstruction was determined by the lacrimal duct irrigation test. The diagnosis of infectious keratitis was made based on clinical manifestations, cornea scraping microscopic examination and bacterial/fungus culture. Diagnosis of viral keratitis was set up based on the recurrent history, deep neovascularization and typical outlook of the cornea scar. The treatment of keratitis included drugs, eye drops or surgery, while treatment of chronic dacryocystitis was lacrimal duct dredging with supporting tube implantation surgery. In the thirty-one eyes with infectious keratitis, fifteen suffered from fungal keratitis (48%), two bacterial keratitis (6%), and fourteen viral keratitis (45%). Eleven eyes (35%) from ten patients with infectious keratitis also suffered from lacrimal duct obstruction. In those cases, six eyes also suffered from lower canalicular obstruction, three nasolacrimal duct obstruction and chronic dacryocystitis, one a combination of upper and lower canalicular obstruction, one upper canalicular obstruction. After local and systemic applications of anti-bacterial, anti-viral, anti-fungal and anti-inflammatory drugs, twenty-eight eyes (90%) recovered within three weeks, while the ulceration of three patients required the lacrimal duct dredging and supporting tube implantation surgery for the healing.Conclusions: Herein, we first report that the prevalence of infectious keratitis is closely correlated to the occurrence of lacrimal duct obstruction. When both confirmed, simultaneous treatment of keratitis and lacrimal duct obstruction promptly is required. Further evaluation of mechanism, prevention and control of the diseases are warranted.     

Endoscopic laser surgery for subglottic stenosis in Wegener's granulomatosis

PURPOSE: Wegener's granulomatosis (WG) is a rare multisystem inflammatory disease, which infrequently involves the subglottic area and trachea. Treatment usually involves the use of immunosuppressive agents with corticosteroids. Some patients, however, continue to have symptoms of airway obstruction after clinical remission following the standard therapeutic regimen. OBJECTIVE: To investigate laser treatment for subglottic stenosis in five patients suffering from WG. MATERIALS AND METHODS: We endoscopically treated 5 patients with subglottic stenosis due to WG and airway obstruction by Nd:YAG and CO2 lasers. One of the patients had preoperative tracheostomy and after treatment was decannulated and could not breathe without dyspnea. Another patient required stenting of the subglottic area. RESULTS: All five patients were able to breathe without dyspnea after the treatment. Three patients were treated with an Nd:YAG laser but needed repeated laser treatment every four to six months, whenever they complained of dyspnea. The other two patients were treated with a CO2 laser; one of these patients had preoperative tracheostomy and was treated twice by CO2 laser and decannulated, with no further difficulty in breathing. The follow-up period was 1-5 years. CONCLUSIONS: Nd:YAG and CO2 lasers are recommended in the treatment of subglottic stenosis (SS) due to WG, particularly when the stenosis is in continuity or close proximity to the vocal cords.     

强脉冲光联合Nd:YAG激光治疗黄褐斑疗效观察

目的:探讨强脉冲光联合Nd:YAG激光治疗黄褐斑的疗效。方法:60例患者按治疗方法不同分成3组:强脉冲光组、Nd:YAG激光组、联合组（强脉冲光联合Nd:YAG激光组）,每组20例患者,观察3组患者疗效和副作用。结果:3组之间疗效两两比较采用Mann-Whitney秩和检验,强脉冲光组和激光组疗效无显著差异,而联合组疗效显著好于强脉冲光组（Z=7.123, P=0.024）和激光组（Z=6.024, P=0.030）。3组患者治疗后均无出现色素沉着加重、色素脱失病等不良反应。强脉冲光组和激光组的满意度无显著差异,而联合组的满意度显著好于强脉冲光组（Z=7.361, P=0.029）和激光组（Z=6.831, P=0.027）。结论:强脉冲光联合Nd:YAG激光治疗黄褐斑是一种安全有效的治疗方法,值得临床推广。     

宫腔镜下Nd:YAG激光治疗子宫内疾病78例分析

目的 :评价宫腔镜对子宫内疾病的诊断价值和采用Nd :YAG激光治疗子宫内疾病的效果。方法 :对 78例子宫内疾病 (包括子宫内粘连、子宫粘膜下肌瘤、子宫纵隔、子宫粘膜息肉、宫颈息肉及宫颈管囊肿 )采用宫腔镜进行诊断 ,并用Nd :YAG激光进行治疗。结果 :宫腔镜诊断子宫内疾病的准确率高于超声诊断及放射诊断。采用Nd :YAG激光治疗的一次性成功率为 97.43 %。手术时间为 2 0 5 5分钟 ,平均 3 5 .7± 18.5分钟。无明显并发症。术后 1 3个月随访 2例病人有残留的粘连带及纵隔组织而进行二次手术。其余患者均恢复正常。 8例患者 (有生育要求者 )在一年内妊娠。结论 :对于子宫内疾病宫腔镜有较高的临床价值 ,采用Nd :YAG激光治疗具有更简便、安全、疗效确切等优点 ,具有广泛的应用前景     

Clinical effectiveness of coblation-assisted inferior turbinoplasty

Background: Laser-assisted inferior turbinoplasty has become accepted as a common treatment for patients displaying allergic rhinitis with severe nasal obstruction. Coblation-assisted inferior turbinoplasty has recently been reported. The aim of this study was to evaluate the effectiveness of coblation-assisted inferior turbinoplasty, compared with laser surgery. Methods: Between November 2004 and May 2007, a total of 29 patients were treated with coblation-assisted inferior turbinoplasty. We evaluated symptom scores at 1 month, 1 year and 2 years after surgery, compared with the results of Nd: YAG laser surgery. Results: At 1 month after surgery, improvement rates of symptom scores were good and similar between coblation- and laser-assisted surgery. At 1 year after surgery, improvement rates of laser surgery had significantly decreased. However, improvement rates of coblation surgery had not changed at 1 and 2 years (sneeze, 64%; nasal discharge, 71%; nasal obstruction, 79%) after surgery. Conclusion: Coblation-assisted inferior turbinoplasty appears effective for the treatment of patients with allergic rhinitis and nasal obstruction.     

Three-dimensional topographic scanning electron microscope and Raman spectroscopic analyses of the irradiation effect on teeth by Nd:YAG, Er: YAG, and CO(2) lasers

A three-dimensional analyzer installed in a scanning electron microscope was used to evaluate the morphology and surface roughness using noncontact profilometry. Observations were carried out on the enamel and dentin surface irradiated by three different lasers: Nd:YAG (wavelength 1.06 microm), Er:YAG (2.94 microm), and CO(2) (10.6 microm). Spectroscopic analysis was done by Raman spectroscopy for nonirradiated and laser-irradiated surfaces. The lasers were applied perpendicularly to vertically sectioned and polished human extracted caries-free molars. The tooth was sectioned at each cavity for cross-section analysis after laser irradiation. Irradiation by Nd:YAG and CO(2) lasers of the enamel surface showed an opaque white color, different from dentin where the surface turned black. The Er:YAG laser induced no changes in color of the dentin. Numerous cracks associated with thermal stress were observed in the CO(2) laser-irradiated dentin. Noncontact surface profile analysis of Er:YAG laser-irradiated enamel and dentin showed the deepest cavities, and direct cross-sectional observations of them showed similar cavity outlines. The CO(2) laser-irradiated dentin had the least surface roughness. Raman spectroscopic analysis showed that fluorescence from the laser-irradiated tooth was generally greater than from nonirradiated teeth. Bands in dentin attributed to organic collagen matrix were lost after Nd:YAG and CO(2) laser irradiation, and a broad peak due to amorphous carbon appeared. The Er:YAG laser-irradiated dentin showed no sign of a carbon band and had more suitable results for dental ablation. Noncontact surface profile analysis was effective to evaluate the structural change in the tooth in the microarea of study after laser irradiation.     

Long-Pulsed Nd:YAG Laser Treatment of Warts: Report on a Series of 369 Cases

Various treatment methods have been adopted in the management of warts; however, there is still no consensus on first-line treatment. This study was designed to evaluate the efficacy of long-pulsed Nd:YAG laser in the treatment of warts. Over the course of 1 yr, 369 patients with recalcitrant or untreated warts were exposed to a long-pulsed Nd:YAG laser. The following parameters were used: spot size, 5 mm; pulse duration, 20 msec; and fluence, 200 J/cm². No concomitant topical treatment was used. In all, 21 patients were lost during follow up; hence, the data for 348 patients were evaluated. The clearance rate was 96% (336 of the 348 treated warts were eradicated). The clearance rate of verruca vulgaris after the first treatment was very high (72.6%), whereas the clearance rate of deep palmopantar warts after the first treatment was low (44.1%). During a median follow-up period of 2.24 months (range, 2-10 months), 11 relapses were seen (recurrence rate, 3.27%). In conclusion, long-pulsed Nd:YAG laser is safe and effective for the removal or reduction of warts and is less dependent on patient compliance than are other treatment options.