【摘要】：目的：對雙淚小管置入式人工淚管置入術與鼻淚管支架置入術在治療慢性淚囊炎疾病的臨床療效觀察，，探討雙淚小管置入式人工淚管置入術在臨床應用中的優(yōu)勢以及推廣價值。 方法：收集2012年8月至2012年12月，北京愛爾英智眼科醫(yī)院門診就診以及住院治療慢性淚囊炎的患者76例（102只眼），按照術式分為兩組，雙淚小管置入式人工淚管置入術組（A組）42例（58只眼），鼻淚管支架置入術組（B組）34例（44只眼）。A組在局麻下行雙淚小管置入式人工淚管置入術，術后常規(guī)淚道沖洗，共七天，之后定期淚道沖洗，術后3個月后拔管，抗炎眼藥水點眼一周。B組在局麻下行鼻淚管支架置入術，術后常規(guī)淚道沖洗，共七天，之后定期淚道沖洗，術后3個月后拔管，抗炎眼藥水點眼一周。隨訪1個月至5個月，平均約2.32個月。療效判定：以淚道沖洗通暢與否及患者溢淚癥狀改善情況作為療效評判標準，治愈：沖洗時無阻力感，淚道沖洗通暢，患者自覺溢淚癥狀消失。好轉：沖洗時有阻力感，口鼻腔內有少許沖洗液；患者自覺溢淚癥狀減輕，但未完全消失。失敗：沖洗時口鼻腔內無沖洗液流出，自原路或經(jīng)上淚小點返流，患者自覺溢淚癥狀無改善或加重。采用SPSS17.0軟件進行統(tǒng)計學分析，對2組的治療效果應用χ2檢驗。上述統(tǒng)計分析均以P＜0.05作為統(tǒng)計學差異具有顯著性意義。 結果：兩組患者均定期隨訪1個月至5個月，平均2.32個月，A組治愈40只眼，好轉14只眼，無效4只眼，治愈率為93.10%。B組治愈23只眼，好轉10只眼，無效11只眼，治愈率為75.00%。兩組治愈率經(jīng)過統(tǒng)計分析差異有統(tǒng)計學意義（χ2=7.41，P0.05）。術中部分患者有疼痛感，但均能耐受手術。術后1周少數(shù)患者鼻腔有血性分泌物，均未做特殊處理。 結論：雙淚小管置入式人工淚管置入術與鼻淚管支架置入術在治療慢性淚囊炎上均有良好療效。根據(jù)兩組治愈率的比較，說明雙淚小管置入式人工淚管置入術對于慢性淚囊炎的治療效果更好，值得在臨床上大范圍推廣，是慢性淚囊炎治療的理想手段之一。
[Abstract]:Objective: To observe the clinical efficacy of double lacrimal canaliculus implantation and nasolacrimal duct stent placement in the treatment of chronic dacryocystitis, and to explore the advantages and popularization value of double lacrimal canaliculus implantation in the clinical application.
Methods: from August 2012 to December 2012, 76 patients (102 eyes) with chronic dacryocystitis were treated in the outpatient department of Beijing AI Ying Zhi ophthalmology hospital, and 102 eyes were hospitalized for chronic dacryocystitis. According to the operation, there were 42 cases (58 eyes) of the double lacrimal canaliculus implantation group (group A), and 34 cases (44 eyes) of the nasolacrimal duct stenting group (Group 44) in the local anesthesia group (group.A). The lacrimal duct implantation was performed for seven days after operation. After the operation, the lacrimal duct was flushed for seven days. After the operation, the lacrimal duct was flushed regularly. After 3 months, the tube was extubation. The anti inflammatory eye drops were placed under local anesthesia for one week. The lacrimal duct was rinsed after the operation for seven days. After the operation, the lacrimal duct was washed regularly. After 3 months after the operation, extubation and anti inflammatory ophthalmic medicine were used. Follow up for 1 months to 5 months, an average of about 2.32 months. The curative effect was judged by lacrimal passage irrigating or not and the improvement of the patient's spilled tears. The patient's conscious dacryocyst symptoms were relieved, but failed to disappear completely. Failure: no irrigating fluid in the mouth and nasal cavity in the rinse and reflux from the original or tacryo punctates. The patients consciously had no improvement or aggravation of the symptoms of the dacryocyst. Statistical analysis was carried out by SPSS17.0 software, and the effect of the 2 groups was tested by the chi 2 test. The above statistical analysis were all P < 0.05. It is significant for statistical difference.
Results: the two groups were followed up for 1 months to 5 months, with an average of 2.32 months, 40 eyes were cured in group A, 14 eyes were improved, 4 eyes were invalid, the cure rate was 23 eyes in group 93.10%.B, 10 eyes improved, and 11 eyes were invalid. The cure rate of group 75.00%. two was statistically significant (x 2=7.41, P0.05). Some patients in the operation were statistically significant (P0.05). There was pain, but they all tolerated surgery. A few patients had bloody secretions in the nasal cavity 1 weeks after operation, and no special treatment was done.
Conclusion: both lacrimal canaliculus implantation and nasolacrimal duct stent implantation have good curative effect in the treatment of chronic dacryocystis. According to the comparison of the cure rate of the two groups, it is proved that the treatment effect of the double lacrimal canaliculus implantation for chronic dacryocystitis is better, the value must be widely spread in the clinic, it is chronic dacryocystitis. One of the ideal means of treatment.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R779.6

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