影响泪道激光成形术疗效因素探究.docVIP

影响泪道激光成形术疗效因素探究 　【摘要】 目的 研究泪道激光成形术治疗泪道阻塞性疾病的疗效及其影响因素。方法 回顾性研究我院开展的泪道激光成形术治疗泪道阻塞性疾病的疗效，并观察年龄、性别、阻塞部位、病程、有无脓性分泌物及术中术后特殊处理6项因素对疗效的影响。结果 我院泪道激光成形术治疗泪道阻塞性疾病的治愈好转率为85.8%；年龄、阻塞部位、有无脓性分泌物及术中术后特殊处理的不同对激光治疗效果影响差异有显著性，而性别及病程对治疗效果影响差异无显著性。结论 年龄、阻塞部位、有无脓性分泌物及术中术后特殊处理是影响泪道成形术疗效的重要因素。 【关键词】 泪道激光成形术 疗效 影响因素 Study on affect factors of laser plastic operation of lacrimal duct 【Abstract】 Objective To study the effect and the affect factors of laser plastic operation of lacrimal duct treating obstructive diseases oflacrimal duct.Methods The results of laser plastic operation of lacrimal duct in treatment of obstructive diseases of lacrimal duct in our hospital by retrospective research were summarized；and the factors such as age’sex’progress’portion of obstruction’having or not purulent discharge andspecialmanagement in or after operation were observed.Results The cure-improve rate of laser plastic operation of lacrimal duct in treatment of obstructive diseases of lacrimal duct in our hospital was 85.8%.There was significant difference inthe factors as age’portion of obstruction’having or not purulent discharge and special management in or afteroperation’and otherwise in the factors as progress and sex.Conclusion Age’portion of obstruction’having or not purulent discharge and special management in or after operation are the important affect factors to the effect of laser plastic operation of lacrimal duct. 【Key words】 laser surgery lacrimal duct obstruction effect affect factors 利用激光治疗阻塞性泪道疾病自1995年在全国广泛开展以来取得了良好效果。虽然泪道激光成形术具有许多优点，然而其最终疗效仍不能令人满意。笔者拟通过对临床开展的泪道激光成形术患者进行回顾性研究以了解影响泪道激光成形术疗效的因素，以供临床中选择性地进行泪道激光成形术。 1 资料与方法 1.1 一般资料 我院自2002年9月以来门诊及住院患者103例(106眼)，男6例，双眼1例；女97例，双眼2例。年龄24～76岁，平均(48.36±14.08)岁。病程6个月～20年，平均(4.95±3.67)年。泪总管及以上阻塞者8眼，泪囊及以下阻塞者84眼，上、下泪道多处阻塞（混合性）者14眼；其中有脓性分泌物者96眼。曾行泪道探通插管治疗后复发11眼，行泪道激光成形术后复发3眼。 1.2 方法 1.2.1 激光成形术方法 泪道注入1%丁卡因黏膜表面麻醉，扩张泪小点及泪小管后插入套针至阻塞部位后插入Nd∶YAG激光(华工HD-110型)光导纤维边激光击射边向下前进，直至顺利到达鼻腔；泪道冲洗通畅后一边注入典必殊眼膏，一边退出套针。术后第2天每日泪道冲洗1次，连续5天后逐渐减少冲洗频率至1个月。 1.2.2 术中术后特