泪小点进路YAG激光辅助下泪囊鼻腔造孔术治疗慢性泪囊炎的效果探究OA
Investigation of the Efficacy of YAG Laser-Assisted Dacryocystorhinostomy via the Lacrimal Puncta Approach in the Treatment of Chronic Dacryocystitis
目的 探讨泪小点进路YAG激光辅助下泪囊鼻腔造孔术治疗慢性泪囊炎的临床效果,并与鼻内镜下泪囊鼻腔吻合术进行对比分析,为临床术式选择提供参考依据.方法 采用分层抽样法选取2023年6月至2025年3月于西安市人民医院就诊且符合研究标准的慢性泪囊炎患者160例,根据1∶1比例将患者分为对照组和观察组,每组80例.对照组接受鼻内镜下泪囊鼻腔吻合术治疗,观察组接受泪小点进路YAG激光辅助下泪囊鼻腔造孔术治疗.比较两组治疗效果、手术指征(术中出血量、手术时间、住院时间)、症状改善情况[视觉模拟评分法(VAS)评分、溢泪分级(Munk)评分]以及并发症发生情况.结果 观察组治疗总有效率(98.75%)高于对照组(91.25%),差异有统计学意义(P<0.05).观察组术中出血量、手术时间、住院时间显著低于对照组(P<0.001).治疗后,两组VAS、Munk评分低于治疗前,且观察组低于对照组(P<0.05).观察组并发症发生率低于对照组,但差异无统计学意义(P>0.05).结论 相较于鼻内镜下泪囊鼻腔吻合术,泪小点进路YAG激光辅助下泪囊鼻腔造孔术具有术中出血量减少、手术与住院时间缩短,以及术后患者恢复进程的加速等临床优势,两种术式均有显著疗效和较高安全性,临床应根据患者实际情况选择手术术式,以达到最佳治疗效果.
Objective To investigate the clinical efficacy of YAG laser-assisted dacryocystorhinostomy via the lacrimal puncta approach in the treatment of chronic dacryocystitis and compare it with nasal endoscopic dacryocystorhinostomy so as to provide reference for clinical selection of surgical method.Methods A stratified sampling method was used to select 160 patients with chronic dacryocystitis who were treated at Xi'an People's Hospital from June 2023 to March 2025 and met the study criteria.They were divided into a control group and an observation group at a ratio of 1∶1,with 80 patients in each group.The control group received endoscopic dacryocystorhinostomy,while the observation group underwent YAG laserassisted dacryocystorhinostomy via the lacrimal punctum approach.The therapeutic effects,surgical indicators(intraoperative blood loss,operation time,hospital stay),symptom improvement[Visual Analogue Scale(VAS)score,Munk score(Munk grading scale)],and incidence of complications were compared between the two groups.Results The total effective rate of the observation group(98.75%)was higher than that of the control group(91.25%),and the difference was statistically significant(P<0.05).The intraoperative blood loss,operation time,and hospital stay in the observation group were significantly lower than those in the control group(P<0.001).After treatment,the VAS and Munk scores in both groups were lower than those before treatment,and the scores in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion Compared with nasal endoscopic dacryocystorhinostomy,YAG laser-assisted dacryocystorhinostomy via the lacrimal puncta approach possesses multiple clinical advantages including less intraoperative blood loss,shorten operation time and hospital stay,and accelerate postoperative recovery.Both surgical procedures show significant efficacy and high safety.The surgical method should be selected according to the patient's specific condition to achieve optimal therapeutic effects.
李春花;张天明;惠娜;田冰玉;朱江;喻磊;冯茂飞
西安市人民医院(西安市第四医院)眼科,西安 710000西安市人民医院(西安市第四医院)眼科,西安 710000西安市人民医院(西安市第四医院)眼科,西安 710000西安市人民医院(西安市第四医院)眼科,西安 710000西安市人民医院(西安市第四医院)眼科,西安 710000西安市人民医院(西安市第四医院)眼科,西安 710000吴忠市人民医院眼科,宁夏 吴忠 751100
慢性泪囊炎泪小点进路YAG激光辅助下泪囊鼻腔造孔术鼻内镜下泪囊鼻腔吻合术
chronic dacryocystitisYAG laser-assisted dacryocystorhinostomy via the lacrimal puncta approachnasal endoscopic dacryocystorhinostomy
《转化医学杂志》 2026 (6)
912-916,5
陕西省重点研发计划项目(2025SF-YBXM-438)
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