顺逆联合全泪道置管术治疗复杂性泪道阻塞

Combined antegrade and retrograde intubation for the treatment of complex lacrimal duct obstruction

目的观察硅胶泪道引流管联合泪道支撑管同时置入治疗复杂性泪道阻塞的临床效果。方法作者设计了一种“顺逆联合全泪道置管术”，即硅胶泪道引流管联合泪道支撑管同时置入术。并进行复杂性泪道阻塞手术26例（26眼），包括泪小管阻塞合并鼻泪管阻塞16例，泪小管狭窄合并慢性泪囊炎7例，N／b管、泪总管和鼻泪管同时阻塞3例。术后定期复查冲洗泪道，3个月时拔管。术后随访3-12个月，观察患者的症状和泪道冲洗的情况。结果26例手术均顺利完成，术中、术后无并发症出现。治愈21眼（80．77％），好转3眼（11．54％），无效2眼（7．69％）。结论顺逆联合全泪道置管手术治疗复杂性泪道阻塞效果可靠。

Objective To observe the clinical efficacy of silicone lacrimal drainage tube combined with retrograde stent tube placement for complex lacrimal duct obstruction. Methods Twenty-six eyes of 26 cases of complex lacrimal duct obstruction were observed, including 16 eyes with both lacrimal canaliculus and nasolacrimal duct obstruction, 7 eyes with lacrimal canaliculus stenosis and chronic dacryocystitis and 3 eyes with lacrimal canaliculus, common canaliculus and nasolacrimal duct obstruction. They underwent com- bined lacrimal duct operation. All patients were followed up for 3 - 12 months. Periodic irrigation of lacrimal passage after operation were conducted, and the tubes were extracted 3 months after surgery. Symptoms and lacrimal duct irrigation condition of patients was observed. Results All the 26 eyes were successfully operated without any complication during operation. Finally 21 eyes were cured （80.77%）, 3 eyes improved （ 11.54% ） and 2 eyes invalid （ 7.69% ）. Conclusion Combined antegrade and retrograde whole lacrimal duct intubation is reliable in treatment of complex obstruction of lacrimal ducts.