鼻泪管泪囊逆行植入球头硅胶管术

Retrograde Insertion of A Spherical Headed Silicon Tube through Nasolacrimal Duct

目的:慢性泪囊炎鼻泪管阻塞是眼科常见而难治眼病之一,目前的各种手术对泪道破坏性大,效果并不满意,为了探索简易,可行、损伤小而又疗效好的方法而进行本文的研究。方法:主要是利用自制7号钝头腰穿针注水送线法,向泪囊—鼻道送—引线,在引线引导下,用特制绳逆行扩大鼻道达3mm径左右的孔道,随后作鼻泪管—泪囊逆行植入相应大小的球头硅胶管,并作停留之。结果:本文研究施行37眼慢性泪囊炎鼻泪管阻塞患者,观察6～17个月,泪道变通畅,治疗率达83.7％,比其他术式效果好。结论:1.鼻泪管泪囊逆行植入球头硅胶管术,方法简便,对病人无痛苦,对正常泪道组织破损、干扰小,反应轻,疗效好。2.本术式可作为治疗慢性泪囊炎、单纯鼻泪管阻塞较为理想的初选术式。3.本术式即使首次失败后,亦可重行施术,或改行泪囊—鼻腔吻合术。眼科学报 1995;11:208—210。

Purpose: Chronic dacryocystitis or obstruction of nasolacrimal duct is one of the common and refractory eye diseases. The present operations have large destruction to lacrimal passage and unsatisfactory effects. The purpose of this research is to explore a simple and easy surgical method that makes small injuries and good curative effects. Methods: Prob a self-made lumbar-puncture needle( No. 7) through the lacrimal drainage system, inject fluid and put a thread into the inferior meatus. Guided by the thread, a special robe is retrogradely pulled through the nasolacrimal duct to dilate the meatus to about 3 mm. Then a silicon tube with a spherical head was inserted in the same may. Results: 37 cases with chronic dacryocystitis or obstruction of nasolacrimal duct were treated by the method and followed up from 6 to 17 months. The result showed that the naso meatus was unobstructed postoperatively. The curative rate was 83. 7% , which is better than that of other surgical methods. Conclusion : This operation is simple and painless for patients; has good curative effects and no severe complications ; seldomly injures the normal lacrimal drainage system; can be done repeatedly or replaced by dacryocystorhinostomy if the procedure fails and will become the primarily elected method th treat the patients with chronic dacryocystitis and obstruction of the nasolacrimal duct. Eye Science 1995; 11:208-210.