鼻窦镜下泪囊鼻腔支架留置的泪囊鼻腔吻合术

Observation EES-DCR with Lacrimal Duct Stents inside Under Sinus Mirror

目的探讨单纯性慢性泪囊炎患者内窥镜下泪囊鼻腔吻合术（EES-DCR）中，在造瘘口放置自制泪囊自制引流支架可行性及有效性。方法选取单纯性慢性泪囊炎40例，行EES-DCR手术，术中在造瘘口中放置自制硅胶材料的泪囊鼻腔引流支架，使鼻粘膜与吻合口前壁紧密相贴。手术后定期冲洗泪道并用鼻腔内窥镜检查造瘘口情况，术后1个月拔出吻舍口泪囊鼻腔引流支架，并随访3-6个月以上。结果40例手术均顺利完成，手术时间45±9min，术后所有患者鼻粘膜均顺利存活，创面恢复平整，造瘘口均通畅，没有肉芽组织增生，没有人工支架移位。结论造瘘口自制硅胶泪囊鼻腔引流支架留置不但提高EES-DCR的手术成功率，而且减少术后护理，是一种简单易行、疗效确切、安全高效的鼻内窥镜下泪囊鼻腔吻合的新方法。

objective To explore idiopathic chronicdacryocystitis sinus microscopically daryocystorhinostomy , in buiding fistula placed homemade lacrimal sac nasal stents feasibility and availability o Methods select overweight and chronic inflammation of 40 cases of lacrimal sae, DO EES-DCR resection , intraoperative in colostomy mouth placed homemade silicon material lacrimal sacnasal stents , make nasal membrane disc and amastomotic front wall closely phase stick~ Postoperatire flash periodically lacrimal duct and sinus endoscopy clolostomy mouth , postoperative anastomotic stents , January uproot and follow-up 36 months above~ Results 30patients oprated successfully completed, operation time average 45 ＋groin ,postoperative all patients with nasal mucosa disc are survives, wound healing , and colostomy moth unobstructed , no granulation tissue hyperplasia, no migration of stents, no granulation tissue hyperplasia no migration of stents o Conclusion Build fistula homemade silicon lacrinal sac nasal cavity drainage stems lien , not only in creased EES-DCR surgical success rate and can reauee postoperative nursing ,is a simple and feasible, effect, safe and effective sinus microscopically lacrimal sac nasal cmatomosis with the new method .