鼻内镜下泪总管开放联合引流管置入治疗泪总管阻塞的疗效观察

Effects of endoscopic common canaliculus opening operation with lacrimaI drainage tube for lacrimal duct obstruction

目的探讨鼻内镜下泪总管开放联合引流管置入治疗泪总管阻塞的有效性及安全性。方法选取2016年3月至2018年3月在南昌大学第三附属医院确诊的泪总管阻塞患者32例(32眼),行鼻内镜下泪总管开放联合引流管置入术。引流管在泪道内留置3~4周后拔除,术后随访6~12个月,观察手术效果及并发症等。结果32眼鼻内镜下泪总管全部开放,术中泪总管再通率为100.0%(32/32)。32眼中,27眼治愈,3眼好转,2眼无效,治疗总有效率为93.8%(30/32)。术中、术后均未发生严重并发症,仅有8眼术中出血,4眼术后眼睑青紫肿胀,均进行妥善处理。结论鼻内镜下泪总管开放联合引流管置入术治疗泪总管阻塞,可以精准定位并充分开放正常段泪总管,成功率较高,安全有效,值得临床推广。

Objective To investigate the effect and safety of endoscopic common canaliculus opening operation with lacrimaI drainage tube for Lacrimal duct obstruction.Methods 32 patients(32 eyes)with lacrimal duct obstruction were examined in the Third Affiliated Hospital of Nanchang University from March 2016 to March 2018,and treated by endoscopic common canaliculus opening operation with lacrimaI drainage tube.LacrimaI drainage tube was removed after 3-4 weeks in lacrimal duct.All patients were followed up 6-12 months.The operation effect and complications were observed.Results In 32 eyes,the common lacrimal duct was opened under nasal endoscopy,and the recanalization rate of the common lacrimal duct was 100.0%(32/32)during the operation.Of the 32 eyes,27 eyes were cured,3 eyes improved,and 2 eyes were ineffective.The total effective rate of treatment was 93.8%(30/32).There were no serious complications during or after the operation,only 8 eyes had intraoperative bleeding,and 4 eyes had swollen eyelid bruises,which were all managed properly.Conclusion Endoscopic common canaliculus opening operation with lacrimaI drainage tube for treating the Lacrimal duct obstruction,could locate precisely and fully open the normal lacrimal duct with high success rate,safe and efficient.