泪点周围肿物切除联合泪道重建术临床观察

Observation on surgical resection combined with lacrimal duct reconstruction for peripunctal neoplasm

目的观察泪点周围肿物切除手术的效果。方法门诊32例（32眼）泪点周围肿物，进行肿物切除术联合泪道环形硅胶支撑管置入泪道重建。肿物行病理学检查。术后4-12周拔除支撑管。术后观察泪点周围肿物有无复发，泪点位置和泪道是否通畅。结果肿物术后病理报告：鳞状乳头状细胞瘤4例，色素痣24例，疣2例，炎性肉芽肿2例。随访观察1年以上，无复发者。28例术后泪点位置正常，冲洗泪道通畅，无溢泪现象；2例因肿物较大，术后泪点口向鼻侧稍有扩大，患者遇刺激时稍有溢泪现象；2例出现下泪点闭锁，再次显微镜下行泪点切开后溢泪现象消失。结论手术切除泪点周围肿物同期联合泪点成形及泪道重建，是恢复泪点功能的有效手段。

Objective To observe the efficacy of surgical resection combined with lacrimal duct reconstruction for the peripunctal neoplasm. Methods The data of 32 eyes of 32 cases with peripunctal neoplasm were reviewed. All cases underwent the peripunctal neoplasm excision combined with annular sililone tube intubation for lacrimal reconstruction. The neoplasm was carried out by pathological examination. The sililone tube was removed after 4 - 12 weeks. The peripunctal neoplasm recurrence, the location of punctum and lacrimal duct unobstructed were observed. Results Histopathology showed nevus in 24 cases, papilloma in 4 cases, verruca in 2 cases and granuloma in 2 cases. Followed-up for 1 year or more, 28 cases（ 87.5% ） got lacrimal patency, 2 cases cured of punctum remain a slight expansion of the stimulation of tears. Two cases of the lower lacrimal puncta occlusion and they were cured after punctoplasty under the microscope. Conclusion The surgical resection combined with lacrimal duct reconstruction for peripunctal neoplasm is an effective method in clinical application. It improves the recovery of lacrimal punctum drainage function.