慢性泪囊炎泪道引流管置入术后导管留置最佳时机探讨

Investigation of the best time for indwelling catheter of patients with chronic dacryocystitis after lacrimal drainage tube implantation

摘要:

目的：探讨慢性泪囊炎行泪道引流管置入术后导管留置的最佳时机。

方法：回顾性选取2011-04/2016-10于我院行泪道引流管置入术的慢性泪囊炎患者143例143眼，根据术后导管留置时间进行分组，其中A组患者50例50眼术后导管留置6wk，B组患者57例57眼术后导管留置9wk，C组患者36例36眼术后导管留置12wk。比较三组患者术后临床疗效、视力、溢泪和复发情况及并发症发生情况。

结果：拔管当天，A组和B组患者临床疗效总有效率(94%和93%)优于C组(39%)(均P<0.0167)，但拔管后3mo，三组患者临床疗效总有效率(56%、51%、36%)、视力、溢泪发生率(46%、53%、56%)均无明显差异。拔管后随访6mo，三组患者术后复发率(4%、7%、19%)无明显差异(P=0.056)，但C组患者术后并发症发生率(25%)明显高于A组(4%)和B组(7%)(均P<0.0167)。

结论：慢性泪囊炎行泪道引流管置入术后导管留置6wk或9wk临床获益优于12wk，更具临床应用价值。

Abstract:

AIM: To investigate the best time for indwelling catheter of patients with chronic dacryocystitis after lacrimal drainage tube implantation.

METHODS: Totally 143 eyes of 143 patients with chronic dacryocystitis after lacrimal drainage tube implantation were selected in our hospital. They were divided into 3 groups including group A(50 eyes of 50 cases)with indwelling catheter in 9wk after tube implantation, group B(57 eyes of 57 cases)with indwelling catheter in 12wk after tube implantation, and group C(36 eyes of 36 cases)with indwelling catheter in 6wk after tube implantation. The clinical efficacy, visual acuity, incidence of epiphora, recurrence rate and incidence of postoperative complications with followed-up among three groups were compared.

RESULTS: On the day of extubation, the total effective rates of the three groups were 94%, 93% and 39%, the difference was statistically significant(P<0.0167). The total effective rates of group A and group B were better than those of group C, and the difference was statistically significant(χ²=30.830, 32.056, P<0.001). At 3mo after extubation, the total effective rates of the three groups were 56%, 51% and 36%, there was no significant difference(χ²=3.454, P=0.178). At 3mo after extubation, there was no significant difference in the visual acuity and the incidence of epiphora among the three groups(P>0.05). At 6mo after extubation, the recurrence rates of the three groups showed no significantly different(P=0.056). The incidence of postoperative complications in three groups were 4%(2/50), 7%(4/57)and 25%(9/36), the difference was statistically significant(χ²=11.048, P=0.004). The incidence of postoperative complications in group C was higher than that in groups A and B(χ²=6.499, 5.934; P=0.011, 0.015).

CONCLUSION: The clinical benefits of 6wk and 9wk after lacrimal drainage tube implantation are better than that of 12wk.