[1]张俊鸽,明帅,周钟强,等.个体化泪点成形术治疗获得性泪点狭窄[J].眼科新进展,2020,40(9):862-866.[doi:10.13389/j.cnki.rao.2020.0196]
　ZHANG Junge,MING Shuai,ZHOU Zhongqiang,et al.The efficacy of individualized punctoplasty surgery for acquired punctal stenosis[J].Recent Advances in Ophthalmology,2020,40(9):862-866.[doi:10.13389/j.cnki.rao.2020.0196]
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个体化泪点成形术治疗获得性泪点狭窄/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年9期
页码:
862-866
栏目:
应用研究
出版日期:
2020-09-05

文章信息/Info

Title:
The efficacy of individualized punctoplasty surgery for acquired punctal stenosis
作者:
张俊鸽; 明帅; 周钟强; 祝磊; 庆惠玲; 王莉红; 柳晓辉
450003　河南省郑州市，河南省人民医院，郑州大学人民医院，河南省立眼科医院，河南省眼科研究所
Author(s):
ZHANG Junge; MING Shuai; ZHOU Zhongqiang; ZHU Lei; QING Huiling; WANG Lihong; LIU Xiaohui
Henan Eye Institute,Henan Eye Hospital,People’s Hospital of Zhengzhou University,Henan Provincial People’s Hospital,Zhengzhou 450003,Henan Province,China
关键词:
获得性泪点狭窄; 泪点狭窄分类; 个体化治疗; 泪点成形术
Keywords:
acquired punctal stenosis;  classification of punctal stenosis;  individualized treatment;  punctoplasty
分类号:
R777.2
DOI:
10.13389/j.cnki.rao.2020.0196
文献标志码:
A
摘要:
目的　探讨个体化泪点成形术治疗获得性泪点狭窄的临床有效性。方法　选取2013年1月至2018年6月在我院诊断为获得性泪点狭窄并行泪点切开成形术的患者，依据手术方式不同分为两组，试验组48例（57眼）依据泪点狭窄的类型不同采用个体化泪点成形术，对膜状/裂隙状泪点行环形泪点切开并置管，马蹄状泪点行泪点增生膜切除，针尖状泪点行泪点扩张并置管；对照组30例（33眼），均采用常规的四剪式泪点成形术。记录患者术前及术后1个月、3个月和6个月的溢泪情况、术眼泪点大小和泪液排出功能，对比两组的功能成功率和解剖成功率，对术中切除的泪点组织行HE染色并观察。结果　术后1个月、3个月、6个月，试验组患眼溢泪及泪液排出功能的改善均优于对照组（均为P＜0.05）。术后1个月、3个月,试验组泪点大小分级构成均优于对照组（均为P＜0.05）；术后6个月，试验组泪点为3级的比例（80.7%）高于对照组（63.6%）,但两组间泪点分级构成差异无统计学意义 (P=0.058)。术后1个月，试验组功能成功率为93.0%，高于对照组的75.8%（P=0.046）；术后1个月和术后3个月，试验组解剖成功率分别为100.0%、89.5%，均高于对照组的51.5%、 72.7%（均为P＜0.05）。结论　根据泪点狭窄类型选择个体化泪点成形术能有效治疗获得性泪点狭窄，术后短期泪点均可达到正常的解剖形态，且功能成功率较高。
Abstract:
Objective　To evaluate the clinical efficacy of individualized punctoplasty surgery for different types of acquired punctal stenosis.Methods　The patients diagnosed as acquired punctal stenosis in Henan Eye Institute, Henan Eye Hospital, Henan Provincial People’s Hospital between January 2013 and June 2018 were retrospectively enrolled in this study. The case group involved 48 patients (57 eyes) who underwent individualized punctoplasty according to the types of punctal stenosis. The detailed surgical procedures included: the membranous and slit types underwent circle punctoplasty with bicanalicular intubation, the horseshoe type underwent punctoplasty purely excision proliferative membrane, pinpoint types underwent punctal dilatation with bicanalicular intubation. The control group involved 30 patients (33 eyes) who underwent the conventional 4-snip punctoplasty. The characteristics of the epiphora, the size of punctum and the lacrimal drainage function were recorded before the surgery and in the following of 1 month, 3 months, 6 months. The functional success rate and anatomical success rate of the two groups were compared and analyzed, and the specimens of excised tissues were collected for pathological analysis by HE staining.Results　The improvement of the epiphora and the lacrimal drainage function in the case group was better than that of the control group 1 month, 3 months, and 6 months after operation (all P<0.05). The punctum grading in case group became significant better than that in control group at 1 month and 3 months after surgery (both P<0.05), and 6 months after surgery, the proportion of punctum grade 3 in the case group (80.7%) was higher than that of the control group (63.6%), but there was no statistically significant difference in the composition of punctum grade between the two groups (P=0.058). Compared with the control group, higher functional success rate at month 1 after surgery (93.0% vs.75.8%) and higher anatomic success rate at month 1 after surgery (100.0% vs. 51.5%) and 6 (89.5% vs. 72.7%) were achieved in case group (all P<0.05).Conclusion　Individualized punctoplasty according to the type of punctal stenosis is effective in treating acquired punctal stenosis, which can help achieving a punctum with normal anatomical and physiological function.

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备注/Memo

备注/Memo:
N/A
更新日期/Last Update: 2020-09-05