泪囊鼻腔吻合联合泪道激光置管治疗泪道多点阻塞

Dacryocystorhinostomy combined lacrimal laser plasty and silicone intubation implantation for lacrimal multi-point obstruction

目的:探索泪道多点阻塞的有效治疗方法。方法:在我院住院治疗的泪道多点阻塞的患者35例,所有患者除鼻泪管阻塞外,均伴有一个以上的上泪道阻塞点。先以泪道激光机对泪小管、泪总管等阻塞部位进行泪道激光成形,然后进行改良的泪囊鼻腔吻合术,术中于上下泪小管及鼻腔内"U"形放置硅胶软管,术后定期冲洗泪道,4wk后拔除硅胶管。随访6mo。结果:所有病例术后无硅胶管脱落,无术中并发症。治愈30例,好转3例,无效2例,治愈率86%,有效率94%。结论:泪囊鼻腔吻合联合泪道激光置管是治疗泪道多点阻塞的有效方法,手术并发症少,术后再通率高。

AIM： To evaluate therapeutic effects of dacryocystorhinostomy combined lacrimal laser plasty and silicone intubation implantation for lacrimal duct with multi-point obstruction. METHODS： Thirty-five patients with one or more point obstruction in upper lacrimal duct received lacrimal laser plasty at first. Then, when the obstruction was broken, modified surgery of dacryocystorhinostomy combined silicone intubation implantation in the both lacrimal ductule was performed. Irrigating of the lacrimal passage was made regularly after operation. The silicone tube was extracted in 4 weeks. The follow-up time was 6 months. RESULTS： There were no intraoperation complications and the silicone tube did not fall off after operation. Irrigating test results of lacrimal passage showed 30 out of the 35 eyes （86%） were cured, improved in 3 cases, 2 cases was ineffective. The cure rate was 86% and the efficiency was 94%. CONCLUSION： Dacryocystorhinostomy combined lacrimal laser plasty and silicone intubation implantation is an effective treatment for lacrimal duct with multi-point obstruction, there are less operation complications and higher rate of recanalization of lacrimal passage.