鼻内镜下泪道激光联合置管治疗复发性泪囊炎探讨

To investigate the lacrimal KTP laser angioplasty combined set of recurrent lacrimal tear duct obstruction

目的探讨鼻内窥镜下KTP激光泪道成形联合泪道置管治疗复发性泪囊炎及其临床疗效。方法对45例(46只眼)复发性泪囊炎采用鼻内窥镜下KTP激光联合泪道置管3个月,术后定期冲洗泪道。结果随访6-24个月,治愈39只眼占84.78%;好转5只眼占10.87%,总有效率95.65%。无效2只眼占4.35%。结论泪囊鼻腔吻合手术失效的原因多为骨孔过小、吻合口处瘢痕愈合、肉芽组织增生,再次手术的刺激可能加重吻合口处瘢痕,术中出血多手术难度加大。KTP泪道激光汽化吻合口黏膜,同时鼻内窥镜直视下将吻合口向四周扩大,联合泪道引流管的置入极大的提高了手术成功率,本手术具有操作简单、创伤小、出血少、时间短、恢复快、安全、疗效高的特点是治疗复发泪囊炎很好的治疗手段,值得临床推广应用。

Objective To investigate the lacrimal KTP laser angioplasty combined set of recurrent lacrimal tear duct obstruc-tion and clinical efficacy canal treatment. Methods 45 patients （46 eyes） with recurrent lacrimal duct obstruction using KTP laser treatment,and lacrimal intubation 3 months,after regular lacrimal irrigation. Results 6-24 months,39 eyes were cured accounted 84.78%;5 eyes better accounted 10.87%,the total efficiency 95.65%. Invalid two eyes accounted for 4.35%. Conclusion The rea-son dacryocystorhinostomy surgery failed,mostly bone hole is too small,anastomotic healing scar,granulation tissue,reoperation may increase stimulus anastomosis scar,increased surgical blood loss more difficult. KTP laser vaporization lacrimal mucosa anas-tomosis,and to expand around the stoma,the United lacrimal drainage tube placement greatly improved the success rate of surgery,this surgery with less trauma,less bleeding,time is short,quick recovery,security,high efficacy characteristics of recur-rence dacryocystitis is a good treatment. Simple operation,should be widely applied.