泪囊鼻腔吻合术失败原因分析及应对方法

Reasons of dacryocystorhinostomy failure and the corresponding managements

目的:分析泪囊鼻腔吻合术失败原因以及相应的应对方法。方法:系统回顾2003-08/2013-02在我院再次手术治疗的34例34眼泪囊鼻腔吻合术失败患者的病例资料。分析手术失败原因,探讨应对方法。术后随访6mo^4a,治愈33例,失败1例。结果:泪囊鼻腔吻合术失败的主要原因是:吻合口肉芽组织堵塞,骨孔位置不正确,术中出血过多,骨孔过小,泪囊未完全切开。结论:术前完善相关检查,术中细致操作,减少术中出血,尽可能制作大小及位置均合适的骨孔,术后坚持行泪道冲洗,能减少手术失败的发生。对于失败病例,再次手术仍可达到治愈效果。

AIM： To analyze the reasons of dacryocystorhinostomy failure and the corresponding managements. METHODS： From August 2003 to February 2013, 34 patients （ 34 eyes ） who had a previous failed dacryocystorhinostomy were re-operated in my hospital. This paper analyzed the reasons of operation failure, discussed corresponding managements. The postoperative follow -up time was from 6mo to 4a. Success of the operation was achieved in 33 of these 34 eyes, not effect in 1 eye. RESULTS： The main reasons of the failure of dacryocystorhinostomy were： anastomotic granulation tissue congestion, bone hole locations were not correct, intraoperative bleeding, bone holes were too small, the decryocysts were un-incision. CONCLUSION： Preoperative perfect relevant examination, intraoperative careful operation, reducing intraoperative bleeding, making the perfect size and location bone hole and lacrimal duct flushing on time can reduce the occurrence of failure. Re -operation of dacryocystorhinostomy is effective in these patients who had a previous failed dacryocystorhinostomy.