泪小管切开联合硅胶管置入治疗泪小管炎临床分析

Chinical analysis of lacrimal ductule incision combined with lacrimal stent intubation for canaliculitis

目的：探讨泪小管切开联合硅胶管置入治疗泪小管炎的临床效果。方法：距内眦睑缘约3mm平行切开眼睑皮肤,暴露膨大脓肿的泪小管,水平切开泪小管,清除泪小管内脓性分泌物、结石及肉芽组织,分别从上下泪小点置入软性硅胶管经泪囊、鼻泪管一同出鼻腔,切除多余扩张的水平部分泪小管前壁,用8-0可吸收缝线间断缝合残余的泪小管后壁,包绕支撑管,重建泪小管。术后观察6~12月。结果：术后1周拆除皮肤缝线,3个月取出泪道支撑管。术后6~12月本组17例（17眼）中,16例（16眼）泪道冲洗畅通,占94.70%。结论：泪小管水平部分管壁切除联合硅胶软管置入,重建泪小管恢复泪道引流功能,疗效好,不易复发,是治疗泪小管炎尤其下泪小管炎较理想的手术方法。

Objective To explore the Chinical analysis of lacrimal ductule incision combined with lacrimal stent intubation for canaliculitis. Methods A paralleling eyelid incision, 3mm below the margin, was performed to expose the bulgy canaliculus.Incising the canaliculus along its full extent.The purulent secretion of canaliculus was curetted, and purulent mate-rial drained.Two ends of silicone tubing are threaded via the superior and inferior puncta, through the lacrimal sac down to the nose, where they are tied. The dilated canaliculus was narrowed by Hemisection and wound was sutured with 8-0 vicryl.The follow-up time was 6-12 months. Results The suture of the skin was removed 1 week after operation and the tubing was left for 3 months.After follow-up 6-12 months, among 17cases（17eyes） the lacrimal passages were irrigated successfully on 16 cases（16 eyes） accounting for 94.7%. Conclusion Canalicular hemisec-tion with intubation is an effective way to treat canaliculitis and reconstruct the canaliculus, low relapse.especially for inferior canalicul-itis.