泪道逆行置管术拔管时间初步探讨

目的:评价泪道逆行置管术后不同拔管时间对手术的有效率及并发症发生率的影响。方法:2009-12/2012-12来本院就诊的慢性泪囊炎患者56例60眼,分为两组,在局部麻醉下将泪道再通管逆行置入鼻泪管内,A组术后1.5mo拔管,B组术后3mo及以上拔管,拔管后随访6mo,观察其有效率及并发症发生情况。结果:所有患者均顺利置入泪道再通管。有效率:A组:共32眼,32眼者拔管时泪道冲洗均通畅。拔管后6mo,治愈21眼(66%),好转6眼(19%),无效5眼(16%),有效率84%。B组:共28眼,28眼患者拔管时27眼泪道冲洗均通畅。拔管后6mo,治愈16眼(57%),好转5眼(18%),无效7眼(25%),有效率75%。两组比较差异无统计学意义(P>0.05)。并发症的发展:A组2眼,B组5眼,两组比较差异无统计学意义(P>0.05)。结论:泪道再通硅胶管留置在泪道内不同时间比较,1.5,3mo及以上者术后有效率相仿,肉芽增殖较少。

Preliminary discussion on extubation time of silicone reverse-intubation

AIM: To evaluate the effective and complications rate of silicone reverse-intubation in treating chronic dacryocystitis with different extubation time after surgery.

METHODS: From December 2009 to December 2012, 56 patients(60 eyes)with chronic dacryocystitis were studied. Silicone tube was placed for 1.5 months(group A)or more than 3 months(group B), and the follow-up was 6 months after extubation.

RESULTS: All eyes were successfully placed silicone tube. In group A(32 eyes), all lacrimal passage were unobstructed after extubation, after 6 months of postextubation, 21 eyes were cured(66%), 6 eyes were improved(19%), 5 eyes were failed(16%), the overall successful rate was 84%. In group B(28 eyes), 27 eyes of lacrimal passage were unobstructed after extubation, after 6 months of postextubation, 16 eyes were cured(57%), 5 eyes were improved(18%), 7 eyes were failed(25%), the overall successful rate was 75%. The difference between two groups had not statistically significance(P>0.05). Two eyes in group A and 5 eyes in group B had complications with no statistically significance(P>0.05).

CONCLUSION: With the time of silicone tube in lacrimal passages before extubation, 1.5 months or more than 3 months, the effective rate were similar, the granulation tissue proliferation is less in the former group.