摘要
目的分析不同泪道置管术在治疗泪道探通失败的先天性泪道阻塞方面的临床效果及影响因素。方法收集2013年3月至2015年3月眼科192例单眼经泪道探通术治疗失败的先天性泪道阻塞患儿临床资料,按置管方式不同分为Ritleng组(Ritleng泪道置管术,96例)和Crawford组(Crawford泪道置管术,96例),根据患者症状改善状况及荧光染料消失试验(FDDT)对比两组患者治疗效果,同时分析两组治疗效果的相关影响因素;两组治疗无效患者作为Ritleng失败组和Crawford失败组,交换手术方式进行治疗,观察治疗效果,分析两组治疗效果的相关影响因素。结果两组痊愈率、总有效率及并发症发生率均无统计学差异(P均>0.05)。Ritleng插管术疗效在不同年龄、病程、泪囊炎病史、脓性分泌物、泪道阻塞程度、既往探通次数等方面有统计学差异(P<0.05,P<0.01);Crawford插管术疗效在不同年龄、泪囊炎病史方面有统计学差异(P<0.05,P<0.01)。交换手术方式治疗后,Ritleng组二次手术治愈率为50.00%,Crawford组二次手术治愈率为11.76%,差异有统计学意义(P<0.05)。Crawford插管术治疗Ritleng失败组疗效在年龄方面有统计学差异(P<0.05)。Ritleng插管术治疗Crawford失败组疗效在不同年龄、泪囊炎病史、脓性分泌物、泪道阻塞程度等方面有统计学差异(P<0.05,P<0.01)。结论 Crawford泪道置管术和Ritleng泪道置管术均可在先天性泪道阻塞经泪道探通失败患者中取得较高成功率,但针对存在脓性分泌物、阻塞程度复杂、既往探通次数较多的患者,Crawford泪道置管术效果更佳。
Objective To compare and analyze the clinical effects and influencing factors of different lacrimal catheter treatment for congenital lacrimal duct obstruction after probe insertion failure. Methods The clinical data of child patients with congenital lacrimal duct obstruction（192 single-eyes） underwent lacrimal passage failure were collected from March 2013 to March 2015. According to the different probing of lacrimal passage surgery,a total of 192 eyes were divided into Ritleng group（Ritleng lacrimal duct catheterization,n = 96） and Crawford group（Crawford lacrimal duct catheterization,n = 96）. Based on the improvement of the patient＇ s symptoms and the results of fluorescein dye disappearance test（FDDT）,the therapeutic effect were compared,and the related factors were analyzed between two groups. Patients with invalid treatment were subdivided into Ritleng failure group and Crawford failure group and received the treatment method of exchange. The therapy effects and related factors were observed and analyzed between two subgroups. Results There were no statistically differences in recovery rate,total efficiency and incidence of complications between two groups（all P〉0. 05）. The treatment efficacy was statistically related with different age,disease duration,history of dacryocystitis,purulent secretions,degree of lacrimal duct obstruction and past probing times in Ritleng group（P〈0. 05,P〈0. 01） and with different age and history of dacryocystitis in Crawford group（P〈0. 05,P〈0. 01）. After exchanging operation method,the success rate of reoperation in Ritleng group was significantly higher than that in Crawford group（68. 75% vs 11. 76%,P〈0. 05） and were statistically related with different age,history of dacryocystitis,purulent secretions,degree of lacrimal duct obstruction in Ritleng group（P〈0. 05,P〈0. 01） and with different age in Crawford group（P〈0. 05）. Conclusion Both Crawford lacrimal catheterization and Ritleng lacrimal catheterization can achieve a higher success rate in treating patients with congenital lacrimal duct obstruction after probe insertion failure,but Crawford lacrimal catheterization is better in treating patients with purulent secretions,more complex of obstruction andmore previous probingtimes.
作者
李瑞宏
戴秀华
LI Rui-hong;DAI Xiu-hua(Tangshan Maternity and Child Health Hospital, Tangshan, Hebei 063000, Chin)
出处
《中国临床研究》
CAS
2018年第3期373-376,共4页
Chinese Journal of Clinical Research
