新型泪道探通引流装置治疗泪小管断裂及泪囊炎的临床研究

Clinical study on repairing canalicular laceration and treating chronic dacryocystitis with application of the nasal lacrimal drainage device

目的 设计、临床应用新型泪道探通引流装置治疗泪小管断裂及鼻泪管阻塞所致泪囊炎。方法 新型泪道探通引流装置由两端金属探子及中间软性硅胶管组成。共 42例患者 (2 7例泪囊炎 ,15例泪小管断裂 ,女 2 3例 ,男 19例 )。首先收敛鼻粘膜 ,在表面麻醉下 ,探通泪道 ,自上下泪小点插入泪道探通引流装置 ,末端引至鼻腔鼻泪管开口处 ,内窥镜下取出探子 ,硅胶管留置在鼻腔内。术后第 1周冲洗 2次 ,术后 1月每周冲洗 1次。术后 3个月取出引流管。结果 2 1例泪囊炎患者均在植管后 1周内症状消失。 6例泪囊炎患者明显好转。15例泪小管断裂者术后流泪症状立即消失。拔管后观察 3个月 ,6例泪囊炎患者复发 ,冲洗泪道不通 ,其余患者痊愈。结论 应用新型泪道探通引流装置治疗由泪小管断裂所致溢泪、泪道狭窄、鼻泪管阻塞所致长期溢泪、流脓具有良好的临床效果 ,组织创伤小 ,疗效显著 。

Objective To repair canalicular laceration, treat nasolacrimal duct obstruction and dilatate the stenosis of nasoalacrimal duct caused by dacryocystitis, we designed and developed the new lacrimal drainage device. Methods The new lacrimal drainage device consists of two parts. Metallic probes were at each end, and a soft silicon tube was in between. Forty two patients (27 patients with dacryocystitis, 15 patients with lacrimal laceration,23 females, 19 males) were treated by the probing of lacrimal passage firstly, the device was inserted into lacrimal drainage system from superior and inferior puncta with topic anesthesia, and then extracting each end of the device in nasal cavity with endoscope. The silicon tube was left in situ for about 3 months. Three months after surgery the device was extracted. Results Symptoms of epiphora disappeared in the first week after surgery. In three months following up after extraction of the silicon tube, the nasolacrimal passage in 21 patients with chronic dacryocystitis and 15 patients with lacrimal laceration were drained well and in 6 patients dacryocystitis recurred.Conclusion The therapy with the new lacrimal drainage device is effective in the repair of canalicular laceration and treatment of chronic dacryocystitis.