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目的:比较泪道鼻腔环形置管术(大O型)、鼻内全泪道环形置管术(P型)、上下泪点间环形置管术(小O型)3种不同置管术治疗泪小管断裂的疗效。方法:对36、33、45例泪小管断裂患者分别用泪道鼻腔环形置管术、鼻内全泪道环形置管术、上下泪点间环形置管术3种方法治疗,于术后1周、2周、1个月、3个月、1年进行随访,行泪道冲洗,观察术后泪道冲洗情况。采用问卷调查留置硅胶管对患者心理、生活的影响情况。对术后有效率采用x2检验,主观评分的比较采用方差分析。结果:大O型、P型和小O型有效率分别为91.7%、93.9%和93.3%,3种方法有效率差异无统计学意义。眼部影响、鼻部影响、外形影响、拔出风险的主观评分,大O型分别为3.42±0.73、4.58±0.73、5.69±0.95、6.36±0.59;P型分别为3.15±0.76、6.46±0.67、1.21±0.65、2.03±0.59;小O型分别为2.20±0.59、0.80±0.55、1.07±0.54、1.40±0.62。3种方法的眼部影响、鼻部影响、外形影响、拔出风险比较,主观评分差异有统计学意义(F=35.689、789.691、492.220、762.232,P<0.01);两两相比时,大O型和P型的眼部影响差异无统计学意义;P型和小O型的外形影响差异无统计学意义,其余两两相比,差异均有统计学意义(P<0.01)。结论:泪道鼻腔环形置管、鼻内全泪道环形置管、上下泪点间环形置管三种泪小管断裂吻合置管术,对于恢复泪道功能,安全有效,疗效相当。上下泪点间环形置管术(小O型),材料消耗少、患者术后眼部鼻部刺激性少、耐受性好、外观影响小、满意度高、术后并发症少,可以作为泪小管吻合置管的首选术式。
OBJECTIVE: To compare the results of three different catheterization techniques, including lacrimal nasal ring catheterization (large O-type), intranasal total lacrimal ring catheterization (P type), upper and lower punctum ring catheterization Efficacy of lacrimal canaliculus rupture. Methods: Thirty-six, thirty-three and forty-five cases of lacrimal canaliculi were treated by lacrimal nasal ring placement, intranasal total lacrimal canalization, and ring catheterization between upper and lower lacrimal punctures. Week, 2 weeks, 1 month, 3 months, 1 year follow-up, lacrimal line washing, observation of postoperative lacrimal duct flushing. Surveying the effect of silicone tube placed on the patient’s psychology and life. The postoperative effective rate using x2 test, the subjective score comparison analysis of variance. Results: The effective rates of large O-type, small P-type and small O-type were 91.7%, 93.9% and 93.3%, respectively. The effective rates of the three methods were not statistically different. The subjective scores of ocular influence, nasal influence, appearance effect and pull-out risk were 3.42 ± 0.73, 4.58 ± 0.73, 5.69 ± 0.95 and 6.36 ± 0.59, respectively; P type were 3.15 ± 0.76 and 6.46 ± 0.67 , 1.21 ± 0.65 and 2.03 ± 0.59 respectively. The small O-type were 2.20 ± 0.59, 0.80 ± 0.55, 1.07 ± 0.54 and 1.40 ± 0.62, respectively. The ocular effects, nasal affection, Subjective scores were significantly different (F = 35.689,789.691,492.220,762.232, P <0.01); when compared with each other, there was no significant difference in the eye size between the O-type and the P-type; P type and O There was no significant difference in the shape of the shape, the other two compared, the difference was statistically significant (P <0.01). Conclusion: The lacrimal nasal ring catheter, nasal lacrimal ring catheter, the upper and lower punctum ring between the three sets of canaliac duct rupture anastomosis, for the restoration of lacrimal duct function, safe and effective, the effect is quite. The upper and lower punctum ring catheterization (small O-type), less material consumption, less postoperative eye nose irritation, good tolerance, the appearance of small, high satisfaction, less postoperative complications, can be used as Tracheal tube anastomosis preferred surgical approach.