泪道阻塞性疾病置管选择及疗效

The choice of the silicon tube implantation methods to the lacrimal duct obstruction diseases and its clinical efficacy

目的根据泪道阻塞患者阻塞部位的不同，选择不同的置管方式，评估其术后的疗效。方法对2013年11月至2014年4月在无锡市第二人民医院眼科就诊的48例（51只眼）泪道阻塞性疾病患者（排除外伤性及先天性婴幼儿道阻塞）中，20例（22只眼）慢性泪囊炎或鼻泪管阻塞的患者行鼻泪管探通＋泪道再通管逆行植入术，17例（18只眼）单纯泪点、泪小（总）管阻塞者行泪小管激光成形＋环形引流管植入术，11例（11只眼）泪点、泪小（总）管阻塞合并慢性泪囊炎或鼻泪管阻塞患者行泪道激光探通＋联合置管。结果拔管后随访2-6个月，鼻泪管探通＋泪道再通管置管组治愈率90．9％（20／22），泪小管激光成形＋引流管环形植入组治愈率83．3％（15／18），泪道激光探通＋联合置管组治愈率81．8％（9111）。总有效率治愈率86．3％（44／51）。结论针对泪道阻塞性疾病患者泪道阻塞部位的不同，选择不同方式的置管手术，简单、有效、可行。

Objective To evaluate the clinical effects of the different silicon tube implantation methods to different parts lacrimal duct obstruction diseases. Methods Forty-eight cases （51 eyes） of lacrimal duct obstruction patients were included （except the trauma patients）, 20 cases （22 eyes） with chronic dacryocystitis or nasolacrimal duct obstruction patients were accepted the surgery of arti- ficial nasolacrimal duct implantation. Seventeen cases （18 eyes） were diagnosed with lacrimal puncta or lacrimal canaliculus obstruction as treated with laser dacryocystoplasty and lacrimal drainage tube implantation. Eleven cases （lleyes） with lacrimal puncta or lacrimal canaliculus obstruction with naso- lacrimal duct obstruction or chronic dacryocystitis were treated with laser probing and artificial naso- lacrimal duct and lacrimal drainage tube conjunct implantation. Results Followed up 2-6 months af- ter extubation. Artificial nasolacrimal duct treated group, The cure rate was 90.9%; lacrimal drainage tube treated group, The cure rate was 83.3%; Artificial nasolacrimal duct and lacrimal drainage tube conjunct implanted group, The cure rate was 81.8%. Conclusions According to the different loca- tion of the lacrimal duct obstruction choose different operation method is simple, effective, reason- able and feasible.