【摘要】： 目的：通過對KTP淚道激光術(shù)后淚道內(nèi)灌注不同藥物療效的比較找到提高淚道激光術(shù)療效的方法。 方法：選擇2008年10月至2009年12月,在延邊大學(xué)附屬醫(yī)院就診的各種淚道阻塞的患者共114名。隨機選擇分為3組,每組40眼。淚道激光后向淚道內(nèi)注入不同的藥物(1)A組KTP淚道激光術(shù)后應(yīng)用絲裂霉素+透明質(zhì)酸鈉(2)B組KTP淚道激光術(shù)后應(yīng)用絲裂霉素+妥布霉素地塞米松眼膏：(3)C組KTP淚道激光術(shù)后單純應(yīng)用妥布霉素地塞米松眼膏。觀察3個月以上,比較分析最終結(jié)果。 判定療效：治愈：術(shù)后溢淚消失,淚道沖洗通暢；好轉(zhuǎn)：術(shù)后溢淚癥狀緩解,加壓淚道沖洗通暢；無效：術(shù)后溢淚或溢膿,淚道沖洗不通暢 結(jié)果：A組治愈34只眼(85.0%),好轉(zhuǎn)2只眼,總有效率90.0%。B組治愈35只眼(87.5%),好轉(zhuǎn)3只眼,總有效率95.0%。C組治愈26只眼(65.0%),好轉(zhuǎn)2只眼,總有效率70.0%。 (1)A組治愈34只眼,B組治愈35眼,兩組比較無統(tǒng)計學(xué)差異(P=0.745,P0.05)；A組總有效36只眼,B組總有效38只眼,兩組比較無統(tǒng)計學(xué)差異(P=0.396,P0.05)。 (2)A組治愈34只眼,C組治愈26眼,兩組比較有統(tǒng)計學(xué)差異(P=0.039,P0.05)；A組總有效36只眼,C組總有效28只眼,兩組比較有統(tǒng)計學(xué)差異(P=0.025,P0.05)。A組療效好于C組。 (3)B組治愈35眼,C組治愈26眼,兩組比較有統(tǒng)計學(xué)差異(P=0.018,P0.05)；B組總有效38只眼,C組總有效28只眼,兩組比較有統(tǒng)計學(xué)差異(P=0.003,P0.005)。B組療效好于C組。 結(jié)論：1、淚道激光術(shù)聯(lián)合應(yīng)用濃度為0.4 mg/ml絲裂霉素C,可以防止淚道創(chuàng)面阻塞,顯著提高手術(shù)療效。 2、淚道激光術(shù)后,絲裂霉素聯(lián)合使用妥布霉素地塞米松眼膏或透明質(zhì)酸鈉無不良反應(yīng),治療效果滿意,是臨床值得推廣應(yīng)用的理想治療方法。 3、淚道激光術(shù)后應(yīng)用濃度為0.4 mg/ml絲裂霉素C,使用安全,短期未見藥物引起的并發(fā)癥,是絲裂霉素治療的比較理想的治療濃度。
[Abstract]:Objective: to find out the method of improving the effect of lacrimal duct laser by comparing the effect of different drugs in lacrimal duct after KTP lacrimal duct laser. Methods: 114 patients with various kinds of lacrimal duct obstruction were selected from October 2008 to December 2009. They were randomly divided into 3 groups with 40 eyes in each group. After lacrimal passage laser injection of different drugs into lacrimal duct (1) A group KTP lacrimal passage laser operation with mitomycin hyaluronate sodium (2) B group KTP lacrimal duct laser with mitomycin tobramycin dexamethasone eye ointment: (3) group C KTP lacrimal passage stimulation Tobramycin dexamethasone eye ointment was used only after photosurgery. After 3 months of observation, the final results were compared and analyzed. Curative effect: cure: lacrimal discharge disappeared after operation, lacrimal passage flushed unobstructed; improvement: relief of lacrimal overflow symptoms, smooth flushing of pressurized lacrimal duct; invalidity: after operation, lacrimal overflow or abscess, The results showed that 34 eyes (85.0%) were cured, 2 eyes were improved, 35 eyes (87.5%) were cured in group 90.0.B, 3 eyes were improved, 26 eyes (65.0%) were cured and 2 eyes were improved in group 95.0.C. The total effective rate was 70. 0%. (1) 35 eyes of 34 eyes were cured in group A and 35 eyes were cured in group B, there was no significant difference between the two groups (P < 0. 745). The total effective rate of group A was 36 eyes and the total effective rate of group B was 38 eyes. There was no significant difference between the two groups (P < 0. 396p 0.05). (2). In group A, 34 eyes were cured in group C, 26 eyes were cured in group C, and there was statistical difference between the two groups (P < 0. 039 鹵0. 05). The total effective effect of group A was 36 eyes (group C), and the total effective effect was 28 eyes in group C (P < 0. 039). The curative effect of group A was better than that of group C. (3) 35 eyes were cured in group B and 26 eyes were cured in group C, there was statistical difference between the two groups (P < 0.05). There was statistical difference between the two groups (P 0.003 P 0.005). The curative effect of group B was better than that of group C. ConclusionThe combined use of 0.4 mg/ml mitomycin C in lacrimal duct laser surgery can prevent lacrimal duct wound obstruction and significantly improve the curative effect after lacrimal passage laser surgery. Mitomycin combined with tobramycin dexamethasone eye ointment or sodium hyaluronate had no adverse effects. It is an ideal treatment method worth popularizing in clinic. 3. After lacrimal duct laser surgery, the concentration of mitomycin C is 0.4 mg/ml. It is safe to use, and there is no complication caused by drugs in a short period of time. It is an ideal therapeutic concentration for mitomycin treatment.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R779.63

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 吳楠,劉翔,劉蘭;應(yīng)用絲裂霉素C、典必殊眼膏輔助激光淚道成形術(shù)的臨床研究[J];第三軍醫(yī)大學(xué)學(xué)報;2003年04期

2 丁小燕,彭壽雄;絲裂霉素C對濾過性手術(shù)眼的影響[J];國外醫(yī)學(xué).眼科學(xué)分冊;2000年01期

3 趙勇潔;;淚道激光術(shù)后不同處理方法的療效觀察和體會[J];國際眼科雜志;2006年03期

4 鐘曉東,何愛群,羅瓊,李凌;KTP激光行淚道疏通375例[J];國際眼科雜志;2004年01期

5 孫敘清,戴青,羅豐年,張磊,李暉;淚道腔內(nèi)激光成形術(shù)遠(yuǎn)期療效分析[J];國際眼科雜志;2001年02期

6 張欣,梁春玲,徐彥;激光聯(lián)合淚道插管治療淚道阻塞106例[J];國際眼科雜志;2005年02期

7 趙漢池 ,劉劍萍 ,余永紅 ,胡愛清 ,王金華;典必殊眼膏治療淚道阻塞的臨床觀察[J];湖北省衛(wèi)生職工醫(yī)學(xué)院學(xué)報;2001年04期

8 柯秀峰,張嶙,袁鸝,羅炎;Nd:YAG激光治療淚管聯(lián)合鼻淚管阻塞[J];南京醫(yī)科大學(xué)學(xué)報;2000年04期

9 匡大立;尹忠貴;吳曉紅;;KTP激光淚道疏通術(shù)后淚道擴張沖洗頻率對其療效的影響[J];眼科新進(jìn)展;2006年11期

10 徐軍,耿智敏,劉青光,劉效恭,韓慶,王康敏,陳明霞;堿性成纖維細(xì)胞生長因子預(yù)防膽腸吻合口狹窄的實驗研究[J];西安交通大學(xué)學(xué)報(醫(yī)學(xué)版);2002年03期

，

本文編號：2225883