鼻泪管支架植入术的改良方法

Modified nasolacrimal duct stenting

目的探索经鼻口导丝轨道鼻泪管支架置入的方法,以克服传统治疗溢泪症手术方法的不足。方法用5F导管自制鼻泪管支架,动脉鞘改制支架输送器。先做顺行泪道造影,明确梗阻部位,用珠头导丝穿过泪道及鼻腔,用新方法建立支架输送轨道,逆行经鼻腔植入支架。结果用该法治疗传统方法支架植入困难泪溢症患者5例,手术技术成功率100%,无严重并发症发生,追踪观察6个月疗效稳定,未发生再次堵塞。结论经眼-鼻-口-鼻-鼻外建立轨道可提高鼻泪管支架植入术的成功率。

Objective Traditional nasolacrimal duct stenting possesses some shortcoming including difficulty of pulling ball head guide wire from the nasal cavity with turbinate hypertrophy and nasal septal deviation. The new method of nose-oral tube track establishment can overcome the forementioned and increase the successful rate. Methods 5 F catheter and arterial sheath were modified to be nasolacrimal duct stem delivery device respectively. Antegrade dacryocystography was taken firstly to display the obstructed site and followed by the modified protocol of inserting the guide wire through nasolacrimal duct and nasal cavity, and establishing the stent delivery track for retrograde stent placement. Results 5 epiphora patients with failure implantation by traditional method were all succeeded through the modified stenting （100%）. During 6-mouth follow-up, no serious complications and reocclusion occurred. Conclusion The establishment of eye-nosemouth-nose of external nasal guide wire track can improve the successful rate of nasolacrimal duct stenting.