不同术式治疗慢性泪囊炎及鼻泪管阻塞疗效系统评价

摘要

Objective To investigate the treatment efficaies of different surgery methods including lacrimal laser angioplasty ,lacrimal endoscopy dredge surgery ,lacrimal bypass surgery and dacryocystorhinostomy , and to create a systematic review .Methods The pa-tients with chronic dacryocystitis and nasolacrimal duct obstruction (218male patients with 226 eyes,231 female patients with 250 eyes) from 2010 to 2013 in our hospital were randomly divided into four groups:A,B,C,D.A of 111 cases with 119eyes for Lacrimal laser tube implant surgery;B of 105 cases with 106 eyes for Lacrimal laser surgery;C of 108 cases with 113 eyes for Endoscopic tears High-way Road surgery;D of 125 cases with 138eyes for Dacryocystorhinostomy .Postoperative follow-up 4 months,analyze the four different surgical treatments in the first month the fourth month after surgeries .Results Four kinds of surgical treatments ,the dacryocystorhinos-tomy is best,the effects of lacrimal laser angioplasty and lacrimal endoscopy dredge surgery are quite (P>0.05),and the lacrimal by-pass surgery needs to be increased .Conclusion Dacryocystorhinostomy is safe and convenient;which shortens the operation time ,patient with little pain and without sequelae .It is worthy of promotion and further research are need .%目的：探讨激光泪道成型术、泪道内镜疏通术、泪道旁路手术、鼻腔泪囊吻合术4种不同术式治疗慢性泪囊炎及鼻泪管阻塞的疗效，建立系统评价。方法将该院自2010-2013年的449例（476眼）慢性泪囊炎及鼻泪管阻塞患者（男性患者218例226眼，女性患者231例250眼）随机分成4组：A，B，C，D组。 A组111例119眼，行泪道激光植管术；B组105例106眼，行泪道激光术；C组108例113眼，行鼻内窥镜下泪道旁路术；D组125例138眼，行鼻内窥镜下泪囊鼻腔吻合术。术后随访4个月，分析术后4种手术在第1个月以及4个月后的不同治疗效果。结果4种手术治疗效果中，鼻腔泪囊吻合术效果最佳，激光泪道成型术和泪道内镜疏通术的治疗效果相当（P＞0．05），泪道旁路手术疗效尚待提高。结论鼻腔泪囊吻合术安全方便，手术时间短，患者痛苦小，无后遗症，值得临床推广和进一步的研究。