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目的评价Nd∶YAG激光联合丝裂霉素C阻塞部位浸润,并使用激素眼水治疗阻塞性泪道疾病的疗效。方法使用带导光纤维的WDJ110B型多功能脉冲Nd∶YAG激光泪道治疗机,对随机分为两组不同部位泪道阻塞患者130例(150只眼)进行治疗。治疗组78例(94只眼)采用单次或多次Nd∶YAG激光照射阻塞部位,阻塞解除后使用0.2 mg/ml丝裂霉素C浸润阻塞部位5 min;对照组52例(56只眼)采用单次或多次Nd∶YAG激光照射阻塞部位,阻塞解除后不使用0.2 mg/ml丝裂霉素C浸润阻塞部位。两组患者阻塞解除后再用庆大霉素注射液、地塞米松注射液和生理盐水冲洗泪道,术后泪道内注入妥布霉素地塞米松滴眼液滴眼液。结果治疗组对泪小点、泪小管、泪总管及鼻泪管阻塞治愈率分别是100%、100%、92.31%及72.73%,总治愈率为83.33%(65/78);对照组分别是85.71%、75.00%、53.33%及55.56%,总治愈率为63.46%(33/52)。两组总治愈率差异显著(P<0.05);不同部位治愈率也均高于对照组(P均<0.05)。结论 Nd∶YAG激光联合丝裂霉素C阻塞部位浸润,并使用激素眼水治疗阻塞性泪道疾病效果满意,是治疗泪小点、泪小管、泪总管及鼻泪管阻塞的理想方法之一。
Objective To evaluate the efficacy of Nd:YAG laser in combination with mitomycin C blockage and steroid eye water in the treatment of obstructive lacrimal duct disease. Methods WDJ110B multifunctional pulsed Nd:YAG lacrimal treatment machine with optical fiber was used to treat 130 patients (150 eyes) randomly divided into two groups with different locations of lacrimal duct obstruction. 78 patients (94 eyes) in the treatment group were treated with single or multiple Nd:YAG laser to block the site of occlusion, 0.2 mg / ml mitomycin C infiltration occlusion site for 5 minutes after the release of obstruction, and 52 cases (56 eyes) ) One or more Nd:YAG laser irradiation occlusion sites, blocking the release of 0.2mg / ml mitomycin C infiltration blocking sites. Two groups of patients with the release of blockage after gentamicin injection, dexamethasone injection and saline wash lacrimal duct, intraoperative lacrimal duct injection of tobramycin dexamethasone eye drops. Results The cure rate of the punctum, lacrimal duct, lacrimal duct and nasolacrimal duct in treatment group were 100%, 100%, 92.31% and 72.73%, respectively. The total cure rate was 83.33% (65/78). The control group was 85.71%, 75.00%, 53.33% and 55.56% respectively. The total cure rate was 63.46% (33/52). The total cure rate was significantly different between the two groups (P <0.05). The cure rates of different sites were also higher than those of the control group (all P <0.05). Conclusion Nd:YAG laser combined with mitomycin C blockage site infiltration, and the use of hormone eye water treatment of obstruction lacrimal duct disease with satisfactory results, is the treatment of punctum, lacrimal duct, tear duct and nasolacrimal duct obstruction is one of the ideal methods .