周慧萍

(温岭市中医院，浙江 温岭 317500)

·基础与临床研究·

KTP激光联合Y型硅胶管泪道内置治疗慢性泪囊炎疗效观察

周慧萍

(温岭市中医院，浙江 温岭 317500)

目的：观察KTP激光联合Y型硅胶管泪道内置治疗慢性泪囊炎的疗效。方法对60例慢性泪囊炎患者用KTP激光加典必殊、迪可罗眼药膏泪道填充(A组)；另80例慢性泪囊炎患者用KTP激光联合Y型硅胶管泪道内置，观察疗效并进行分析(B组)。结果术后6个月随访，A组治愈33例，好转10例，有效率71.6%；B组治愈59例，好转12例，有效率88.7%。治愈率及有效率差异均具有统计学意义(P<0.01)。结论KTP激光具有创伤小，出血少，可重复性，适应证广等特点，配合Y型硅胶管内置疗效更好。

KTP激光；Y型硅胶内置管；慢性泪囊炎；疗效

Abstract：[Objective] To study the clinical effects of treatment of chronic dacryocystitis with KTP lacrimal laser combined with intubation of Y type silica gel tube. [Method] Nasolacrimal ducts of sixty cases of chronic dacryocystitis (group A) were reformed by KTP laser, and then were filled with TobraDex and ofloxacin ointment. Another eighty chronic dacryocystitis patients (group B) were treated by KTP lacrimal laser combining with intubation of Y type silica gel tube. [Result] A 6-months follow-up was carried out to all patients. 33 patients were cured and 10 patients were on the mend in group A. The total effective rate was 71.6%. In group B, 59 patients were cured and 12 patients were on the mend. The total effective rate was 88.7%. There were Statistically significant differences in cured rate χ2=25.26(p<0.01)and effective rate χ2=30.17(p<0.01 )between two groups. [Conclusion] KTP laser is a safe, timesaving, less bleeding method with good repeatability and has wide application. Moreover, combined with Y type silica gel tube, it can lead to better curative effect.

Keywords：KTP laser； intubation of Y type silica gel tube；chronic dacryocystitis；curative effect

慢性泪囊炎是常见病多发病，治疗慢性泪囊炎的方法有多种，其中鼻腔泪囊吻合术最为经典。但该术式改变了原泪道的生理结构，且手术繁、出血多，对年少、年长，泪囊小、鼻粘膜萎缩及有全身较严重基础疾病者均不宜施行。随着医学的发达，人们对泪液排泄原理的了解日渐深入，探讨一种能保留泪囊、恢复生理通道，且操作简单、创伤小、适应证广的替代手术[1],一直是眼科医生讨论的热点。笔者自2006年6月至2011年6月，采用磷酸钛氧钾(Ktiop4，以下简称KTP)激光联合Y型硅胶管泪道内置，疗效较好，现报告如下。

1 资料与方法

1.1 一般资料

选择慢性泪囊炎患者140例，随机分为A组60例，B组80例，其中男性45例，女性95例，年龄最小13岁，最大76岁，病程最长13年，最短1.5年。术前均作鼻腔常规检查，排除下鼻甲肥大，严重鼻中隔弯曲及慢性副鼻窦炎积脓者。A组为KTP激光加典必殊、迪可罗眼膏泪道填充，B组为KTP激光联合Y型硅胶管内置。……