摘要
目的比较不同类型泪道置管方式治疗泪道阻塞疾病的疗效差异,并分析影响疗效的相关因素。方法回顾性分析2017-01/2019-10月在武汉协和医院行泪道置管手术治疗泪道阻塞的123眼(96例)患者病例资料,分为泪道顺行置管组(67眼)和逆行置管组(56眼),分别置入U型硅胶泪道引流管(U管)和ND-09B型泪道扩张引流管(B管)。拔管后随访6个月,观察患者功能预后(即患者主观症状)及解剖预后(即泪道冲洗结果),及不同阻塞部位两组患者的功能预后及解剖预后,比较并分析两组间疗效差异。采用Logistic回归分析影响术后疗效的独立因素。结果泪道顺行置管组和逆行置管组患者术后解剖有效率比较,差异有统计学意义(86.57%vs.82.14%,Z=-1.985,P=0.047);泪道顺行置管组和逆行置管组患者术后功能有效率比较,差异有统计学意义(85.07%vs.82.14%,Z=-2.012,P=0.044)。两组在单纯上泪道阻塞、单纯下泪道阻塞及全泪道阻塞中术后功能有效率及解剖有效率进行比较,无统计学差异(P>0.05)。病程是影响患者解剖预后的独立因素(OR=0.524,95%CI:0.336~0.817),伴有黏液性分泌物是影响患者功能预后的独立因素(OR=0.222,95%CI:0.051~0.957)。结论泪道置管术治疗泪道阻塞效果显著,泪道顺行置管预后较逆行置管疗效好。病程、黏液性分泌物是影响患者手术预后的独立影响因素。
Objective To compare the therapeutic efficacy of different types of lacrimal duct intubation in the treatment of lacrimal duct obstruction and analyze the influential factors of the prognosis.Methods Clinical data of 96 cases of 123 eyes with lacrimal duct obstruction treated by lacrimal duct intubation in Wuhan union hospital from January 2017 to October 2019 were retrospectively analyzed.They were divided into the lacrimal duct antegrade intubation group(n=67 eyes)and the retrograde intubation group(n=56 eyes),which was placed with a U-shaped silicone lacrimal drainage tube(hereinafter referred to as U tube)and ND-09 B type lacrimal duct retractable drainage tube(hereinafter referred to as B tube).Follow-up observations for 6 months after extubation were made on the functional prognosis(i.e.subjective symptoms)and anatomical prognosis(i.e.lacrimal irrigation results)of the patients,and the functional prognosis and anatomical prognosis of the two groups at different obstruction sites,and the curative effect difference between the two groups was compared and analyzed.The independent factors affecting the postoperative outcomes were analyzed by Logistic regression.Results There were statistically significant differences in postoperative anatomical efficiency between the lacrimal duct anterograde intubation group and the retrograde intubation group(86.57%vs.82.14%,Z=-1.985,P=0.047).There were statistically significant differences in postoperative functional efficiency between the lacrimal duct anterograde intubation group and the retrograde intubation group(85.07%vs.82.14%,Z=-2.012,P=0.044).There was no statistical difference in postoperative functional and anatomical efficiency between the two groups in pure upper lacrimal duct obstruction,pure lower lacrimal duct obstruction and total lacrimal duct obstruction(P>0.05).The course of disease was an independent factor affecting anatomic prognosis of patients(OR=0.524,95%CI:0.336-0.817).Mucinous secretion was an independent factor affecting the functional prognosis o
作者
张文博
柯超
张希
陈飞
李宛
ZHANG Wenbo;KE Chao;ZHANG Xi;CHEN Fei;LI Wan(Department of Ophthalmology,Wuhan Hongshan Aier Eye Hospital,Wuhan Hubei 430073,China)
出处
《华南国防医学杂志》
CAS
2021年第11期810-814,823,共6页
Military Medical Journal of South China
基金
2017年武汉市卫健委计划项目(2017060201010188)。
关键词
泪道阻塞
顺行置管
逆行置管
功能预后
解剖预后
影响因素
Lacrimal duct obstruction
Anterograde intubation
Retrograde intubation
Functional prognosis
Anatomical prognosis
Influential factors
