78例泪道再通管植入术治疗慢性泪囊炎的临床观察

Clinical observation of 78 cases of lacrimal duct recanalization tube implantation for the treatment of chronic dacryocystitis

目的探讨一次性泪道再通管植入术治疗慢性泪囊炎的临床疗效。方法收集2008年3月至2013年10月承德市中医院眼科门诊收治的78例慢性泪囊炎患者的临床资料，进行回顾性分析。其中男性32例（32只眼），女性36例（36只眼），行一次性泪道再通管逆行植入术。术前行泪道碘油造影，所有患者的手术均由同一术者操作。术后对患者随访12个月，观察术后有效率。结果本研究病例术中2例（2只眼）患者植入泪道再通管失败，其原因考虑与骨性泪道狭窄、泪道激光术后有关；其余76例（76只眼）患者均顺利植入。术后3～7d冲洗泪道，6例（6只眼）患者泪道不通，并有少许陈旧性血凝块；术后6个月拔管，冲洗泪道仍不畅通；其中3例（3只眼）患者再通管半脱位，2例（2只眼）患者鼻泪管开口处肉芽阻塞，1例（1只眼）患者下鼻甲肥大；6例（6只眼）患者均放弃再治疗。其中13例（13只眼）患者冲洗通畅。但自觉少许溢泪。术后对患者随访观察12个月，治愈者57例（57只眼），治愈率为73．1％；好转者13例（13只眼），占16．7％；无效者6例（6只眼），占7．7％；失败者2例（2只眼），占2．6％，总有效率为89．7％。结论一次性泪道再通管植入治疗慢性泪囊炎操作简单，有效率高，值得临床推广。

Objective To explore the clinical effect of disposable lacrimal duct recanalization tube implantation for the treatment of chronic daeryoeystitis. Methods Collect the clinical data of 78 patients with chronic dacryocystitis who visited the Ophthalmology Department of Hospital of Chinese Medicine of Chengde City from 2008 March to 2013 October,including 32 males （32 eyes） ,36 female eases （36 eyes）. They were treated with disposable lacrimal duct recanalization tube implantation and preoperative lacrimal iodine oil radiography was adopted as well. The operations were conducted by the same doctor. After the surgery, a 12-month follow-up is used to observe the postoperative efficiency. Results Among the 78 patients （78 eyes） with chronic dacryocystitis, 57 were cured and the cure rate was 73.1% ;13 noticed improvement in their eyes, accounting for 16.7% ;6 felt the same as before the operation, accounting for 7.7% , 2 failed, accounting for 2. 6%. According to the 12-month follow-up, the total effective rate was 89. 7%. Conclusions Disposable lacrimal duct recanalization tube implantation in the treatment of chronic dacryocystitis is easy to operate and very effective. Thus, it is worth promoting clinically.