记忆引导方式泪道环形置管治疗先天性鼻泪管阻塞

Memory guide way of lacrimal duct circular catheter for congenital nasolacrimal duct obstruction

目的探讨一种国内先天性鼻泪管阻塞治疗方法。方法回顾分析了35例（48只眼）于2009年8月至2012年12月在新疆乌鲁木齐解放军第474医院全军眼科中心就诊，诊断为先天性鼻泪管阻塞（CNLDO）的患儿，均经其他医院或门诊采取保守治疗、加压泪道冲洗和（或）泪道探通法，随访3—16个月，而治疗无效后而收治住院，在全身麻醉下采取一种特制泪道探针泪道探通方式，在可记忆钢芯引导下行上、下泪道环形置人超细软硅胶管术。术后随访6～24个月，以溢泪及伴有脓性分泌物完全消失为治愈标准。结果35例（48只眼），治愈44只眼，治愈率91．7％；3只眼仍有少许流泪，但伴随的脓性分泌物明显减轻；1只眼因术前已形成泪囊瘘管，治疗3周复查时再次形成急性泪囊炎，有大量脓性分泌物，采取拆除泪道环形置管，全身及眼局部应用抗生素，炎症得以控制。结论此手术方法治疗小儿CNLDO安全可靠，疗效好。

Objective To develop a kind of domestic congenital nasolacnmal duct oostrucuon treatment. Methods Reviewed 35 cases and eye successively in Xinjiang Urumuqi autonomous re-gion in the 474th hospital of PLA army ophthalmic center after a diagnosis of congenital nasolacri-mal duct obstruction （CNLDO） of children, they were first in other hospital or outpatient service in our hospital to conservative treatment, pressure lacrimal duct flushing and/or lacrimal duct agent through law, follow-up of 3-16 months, in the treatment of invalid cases in our hospital eye hospi-tal, under general anesthesia to take a new and unique treatment - special lacrimal duct probe lacri-mal duct general agent in memory steel core under the guidance of upper and lower lacrimal duct ring into super soft silicone tube operation. Were followed up for 6 to 24 months, to overflowing with tears and purulent secretion disappear completely cure for standard. Results The operation method was used to treat 35 cases with cure rate 91.7%; 3 eye still had a few tears, along with pu-rulent significantly reduce; 1 eye for preoperative had formed lacrimal sac fistula, three weeks after treatment when reviewed again from acute dacryocystitis, there were a large number of purulent se-cretion, take timely demolition of lacrimalduct circular catheter and systemic adequate application of antibiotic and eye local point with antiphlogistic eye drops, inflammation could be able to control. Conclusions The surgical method to treat in the young child CNLDO is a kind of home, our eye center independent fish out of the way of operation, safe and reliable, and has good curative effect, simple, low cost, can be in hospital at all levels widely develops, is worthy to be popularized.