不同手术方法治疗鼻泪管阻塞继发泪囊炎的临床研究

目的：对比分析三种术式治疗鼻泪管阻塞继发泪囊炎的疗效以及安全性,探索临床治疗鼻泪管阻塞继发泪囊炎的最佳术式。方法：选取2010-01/2016-01我院收治的鼻泪管阻塞继发泪囊炎患者348例397眼作为研究对象,根据手术治疗方案不同分为3组：泪道激光组接受泪道激光成行术治疗130例152眼、鼻泪管组接受人工鼻内管支架植入术治疗113例127眼、鼻内镜组接受鼻内镜泪囊鼻腔吻合术治疗105例118眼,对比分析3组患者的治疗效果及不良反应发生率。结果：术后1mo,3组患眼治疗效果差异有统计学意义( P<0.05),泪道激光组治疗效果显著优于鼻泪管组、鼻内镜组(P<0.05),鼻泪管组与鼻内镜组治疗效果相比差异无统计学意义(P>0.05)。术后4mo,3组患眼治疗效果比较结果与术后1 mo完全一致,但是3组患者术后4 mo的治疗效果均显著变差,差异有统计学意义(P<0.05)。3组患者不良反应发生率差异有统计学意义(P<0.05),泪道激光组不良反应发生率显著低于鼻泪管组、鼻内镜组,差异有统计学意义(P<0.05),鼻泪管组与鼻内镜组不良反应发生率相比差异无统计学意义(P>0.05)。3组患眼复发
　　率比较差异无统计学意义(P>0.05)。结论：泪道激光成行术治疗鼻泪管阻塞继发泪囊炎的疗效与安全性均良好。

Different surgical methods in the treatment of nasolacrimal duct obstruction secondary dacryocystitis controlled clinical studies

AIM: To compare three kinds of surgical treatment of nasolacrimal duct obstruction secondary to the efficacy and safety of dacryocystitis, and to explore the clinical treatment of nasolacrimal duct obstruction secondary to the best operation for dacryocystitis.

METHODS: A total of 348 cases with nasolacrimal duct obstruction secondary dacryocystitis patients(397 eyes)were selected in Jan.2010 to Jan.2016 of our hospital as the research object. According to the treatment of surgery, the research subjects were divided into three groups respectively. The lacrimal duct laser group(130 patients, 152 eyes), the nasolacrimal duct group(113 patients, 127 eyes)and the nasal endoscopy group(105 patients, 118 eyes)of lacrimal duct laser group patients accepted the treatment of lacrimal duct laser lines. Nasolacrimal duct group patients received artificial nose tube stents implantation treatment, patients with nasal endoscopy group underwent anastomosis of lacrimal sac nasal endoscope. The therapeutic effect in three groups of patients and the incidence of adverse reactions were analyzed.

RESULTS: After 1mo, 3 groups of eye treatment effect were statistically significant difference(P<0.05). Lacrimal duct effect of laser treatment group significantly was better than that of the nasolacrimal duct and nasal endoscopy group(P<0.05). The nasolacrimal duct group compared with the effect of nasal endoscopic treatment group was no statistically significant difference(P>0.05). Postoperative 4mo, 3 groups of eye treatment effect comparison results were completely accorded with postoperative 1mo. But the three groups of 4mo after treatment were significantly difference with postoperative 1mo(P<0.05). The incidence of adverse reactions difference in 3 groups was statistically significant(P<0.05). The incidence of adverse reactions of lacrimal duct laser group was significantly lower than the nasolacrimal duct and nasal endoscopy group(P<0.05). The nasolacrimal duct incidence of adverse reactions compared differences between groups with and nasal endoscopy had no statistically significant(P>0.05). Three groups of eye recurrence rate comparison difference had no statistically significant(P>0.05).

CONCLUSION: For the treatment of lacrimal duct laser lines nasolacrimal duct obstruction secondary efficacy and safety of dacryocystitis were good.