泪囊鼻腔吻合术联合超细泪道管置入治疗难治性泪道阻塞疗效观察

Clinical report of dacryocystorhinostomy combine placed with supper- thin Tube to treat the severe lacrimal duct obstruction

目的探讨泪囊鼻腔吻合术联合超细泪道管置入治疗难治性泪道阻塞的临床效果。方法回顾总结邵阳县人民医院2004年5月至2008年5月收治难治性泪道阻塞42例(51眼),术中泪囊探查及泪道浚通、骨孔制作、超细泪道管环形置入,术后常规处理,3个月后拔管,随访3个月至4年。结果术后3个月内仅极少数患者存在轻度溢泪、异物不适及眼内眦部充血,无泪道管脱落、泪小点撕裂及其他并发症。拔管后随访观察3个月～4年,治愈45眼,治愈率为88.24%(45/51);有效5眼,有效率为9.80%(5/51);无效1眼,无效率为1.96%(1/51)。结论泪囊鼻腔吻合术联合超细泪道管置入治疗泪小管阻塞、小泪囊效果良好,扩大了传统泪囊鼻腔吻合术的适应症,该手术设备简单、直视下操作、手术难度小适用基层。

Objective To evaluate the effect of the severe lacrimal duct obstruction with treatment of dacryocystorhinostomy combine placed with supper- thin tube.Methods Between May 2004 to May 2008,42 cases（51 eyes） of severe lacrimal duct obstruction were chose to treat,during the dacryocystorhinostomy,we placed the supper- thin tube to improve the clinical effect,the tube were kept in place for three months after operation.All cases were followed up from three months to four years.Results After operation three months,the effect was perfectly except slight ephiphora of conjunctival congestion in internal canthus in a few cases there was no other complications such as tube fallen off and canalicular dilacerations.After follow-up time from three months to four years,45 eyes（88.24%） were cured,5 eyes（9.80%） were improved,1 eye（1.96%） was invalid.Conclusion The dacryocystorhinostomy combine placed with supper- thin tube is a simple method of operation,and it has better effect to the severe lacrimal duct obstruction.