双泪小管置管术治疗泪道阻塞的临床方案

Clinical protocol of bicanalicular intubation for the treatment of lacrimal duct obstruction

双泪小管置管术是目前治疗泪道阻塞的重要方法,经泪小管内镜下泪小管成形以后,行双泪小管置管术可明显提高泪囊前泪道阻塞的治愈率。由于地区、经济与医疗发展不平衡,在双泪小管置管术推广与普及过程中,存在许多问题,如手术适应证把握不准确、手术操作不规范、手术并发症较多、疗效差异较大等,急需形成相应的专家推荐方案并对手术医生进行规范化培训。为临床医生提供规范的双泪小管置管术治疗泪道阻塞的理论依据,中国中西医结合学会眼科专业委员会泪器病学组及中国医师协会眼科医师分会泪器病专业委员会组织有关专家以临床实际为基础建立本方案,内容包括双泪小管置管术的定义和分类、双泪小管置入式人工泪管的种类及优缺点、手术适应证和禁忌证、术前准备、麻醉及手术操作方法、术后处理及随访、注意事项。

Bicanalicular intubation is an important method for the treatment of lacrimal duct obstruction at present.Evidence showed that bicanalicular intubation could significantly improve the cure rate of pre-lacrimal sac obstruction after canaliculoplasty assisted by transcanalicular endoscopy.Due to the imbalance of regional,economic and medical development,there are many problems in the promotion and popularization of bicanalicular intubation,such as inappropriate surgical indications,nonstandard surgical operations,many surgical complications,and great differences in curative effects.It is urgent to form a corresponding expert recommendation scheme and provide standardized training for ophthalmologists.To provide the clinicians with the theoretical basis for the standardized bicanalicular intubation for the treatment of lacrimal duct obstruction,experts of the Professional Committee of the Lacrimal Disease of Ophthalmology Branch of Chinese Association of Integrated Medicine(CAIM),and the Professional Committee of the Lacrimal Disease of Ophthalmologist Branch of Chinese Medical Doctor Association(CMDA)organized relevant experts to establish this scheme based on clinical practice,including the definition and classification of bicanalicular intubation,the types,advantages and disadvantages of lacrimal stent,indications and contraindications of the operation,preoperative preparation,anesthesia and operation methods,postoperative treatment and follow-up,and the matters needing attention.