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目的 探讨泪道探通术联合球头型泪道扩张引流管植入治疗鼻泪管阻塞的效果及应用价值.设计 回顾性病例系列.研究对象 齐齐哈尔市五官医院慢性鼻泪管阻塞患者152例(152眼).方法 将患者随机分为观察组和对照组,每组各76例.对照组采用泪囊鼻腔吻合术治疗,观察组采用泪道探通术联合球头型泪道扩张引流管植入治疗.比较两组患者的疗效、遗留瘢痕率、术中出血量和手术时间.治愈:术后患者泪道冲洗通畅,无溢泪;好转:术后泪道冲洗可见部分反流,无溢泪或少许溢泪;无效:术后患者泪道冲洗不通,溢泪无改善或者加重.主要指标 总有效率、遗留瘢痕率、术中出血量和手术时间.结果 观察组和对照组的总有效率分别为80.26％和89.47％(P=0.756).观察组患者治疗后遗留瘢痕率(0.00％)明显低于对照组(22.37％)(P=0.006),术中总出血量(10.53±3.20 ml)也明显低于对照组(50.20±10.21 ml)(P=0.000),手术时间(10.01±5.41分钟)明显短于对照组(58.05±12.19分钟)(P=0.000).结论 采用泪道探通术联合球头型泪道扩张引流管植入治疗慢性鼻泪管阻塞疗效与泪囊鼻腔吻合手术相当,但前者可减少手术后遗留瘢痕,缩短手术时间,易于被患者接受,值得在临床上推广使用.“,”Objective To observe the efficacy and application value of the lacrimal duct probing combined with the ball head type lacrimal duct expansion drainage tube implantation for the nasolacrimal duct obstruction.Design Retrospective case series.Participants 152 patients (152 eyes) with chronic nasolacrimal duct obstruction in Qiqihaer Wuguan Hospital.Methods The 152 cases were randomly divided into observation group (76 cases) and control group (76 cases).The dacryocystorhinostomy surgery was performed in the control group,and the lacrimal duct probing combined with the ball head type lacrimal duct expansion drainge tube was performed in the observation group.Then the curative effect,scarring rate,the bleeding volume and the operation time were recorded.Cure was defined when the postoperation syringing of lacrimal passages was smooth and no epiphora.Improving was defined when the part reflux or no epiphora or a little was visible through postoperative lacrimal duct flushing.Failure was defined when no effected or even worse than before.Main Outcome Measures The total effective rate,scar formation rate,bleeding volume and operation time.Results The total efficiency in the observation group and the control group was 80.26％ and 89.47％,respectively (P=0.756).The scar formation rate in the observation group (zero) was significantly lower than that in the control group (22.37％) (P=0.006).The bleeding volume of observation group (10.53±3.20 ml) was significantly less than the control group (50.20±10.21 ml) (P=0.000).The operation time of observation group (10.01±5.41 min) was significantly shorter than in the control group (58.05±12.19 min) (P=0.000,0.000).Conclusion The curative effect of the lacrimal duct probing combined with the ball type lacrimal expansion drainage tube implantation for the treatment of naso lacrimal duct obstruction is equal to that of the dacryocystorhinostomy,but which can reduce the postoperative scar,shorten the operation time,easy to be accepted by patients,worthy to be popularized in clinic.