自制金属支架治疗鼻泪管阻塞

Self-made metal stent in treatment of nasolacrunal duct obstruction

目的 探讨自制金属支架治疗鼻泪管阻塞的临床效果。方法对15例18只眼鼻泪管阻塞植入自制不锈钢丝支架。先行泪道冲洗探通,从上泪点顺行插入导丝,沿导丝逆行引入扩展器,然后用导管鞘将金属支架植入鼻泪管阻塞段。术前与术后做泪道造影检查。结果术后泪道造影均通畅,溢泪完全消失11例13只眼,好转4例5只眼。随访61～219d,平均167d,仅2例2眼手术后3个月复发,阻塞的病例经手术取出支架,有肉芽组织增生。结论自制金属支架治疗鼻泪管阻塞是一种简单、安全、价廉、有效的方法。

Objective To evaluate application of self-made metal stent in treatment of nasolacrimal duct obstruction. Methods In total 15 cases, self-made metal stents made of stainless steel wire were implanted in 18 obstructed nasolacrimal ducts. The lacrimal passages were rinsed and re - canalized followed by antegrade inserting the guide wire from upper dacryon. A dilator was inserted over the guide wire, and then a stent was released from a sheath into the impaired section of nasolacrimal duct. Dacryocystography was performed before and after the inter-ventional procedure. Results Dacryocystography showed patent nasolacrimal duct after treatment. Epiphora disappeared completely in 11 cases (13 ducts), improved in 4 cases (5 ducts). These cases had been followed up for 61 -219 days (167 days in average). Relapse was found in 2 cases (2 ducts) in three months. Those 2 stents were removed by surgical procedure and found occluded by granulation. Conclusion Interventional placement of the self?made metal stent is a simple, safe, low ?cost and effective treatment of the nasolacrimal duct obstruction.