泪道内窥镜直视下环钻术联合硅胶管植入治疗鼻泪管阻塞  

Micro-trepan combined with silicone implantation on obstruction of nasolacrimal duct under lacrimal duct endoscopy

作　　者：袁鹂[1] 张晓俊[1] 沈素民[1] 

机构地区：[1]南京医科大学第二附属医院眼科,江苏省南京市210011

出　　处：《眼科新进展》2008年第12期930-931,934,共3页Recent Advances in Ophthalmology

摘　　要：目的观察在泪道内窥镜下环钻术联合硅胶管植入治疗鼻泪管阻塞的疗效。方法选择2007年2月至11月收治的47例(62眼)鼻泪管阻塞患者,应用微型三通道泪道内窥镜检查,直视下动态观察泪道黏膜及狭窄部位,以环钻解除阻塞,并逆行植入硅胶管,术后1～3个月后拔管,随访半年,以泪道内窥镜观察泪道通畅情况。结果47例(62眼)治疗后,治愈59眼,治愈率达95.1;好转2眼(3.2);无效1眼(1.6)。结论泪道内窥镜直接观察泪道细小病变,并进行环钻术治疗,避免了手术对正常组织的损伤及假道形成,可直接作用于已狭窄阻塞的鼻泪管,恢复鼻泪管的生理结构,是较为理想的治疗方法。Objective To investigate the curative effects of micro-trepan combined with silicone implantation treating obstruction of nasolacrimal duct under lacrimal duct endoscopy.Methods From February 2007 to November 2007,47 cases（62 eyes） with obstruction of nasolacrimal duct were selected.With micro-three channel lacrimal endoscopy,lacrimal mucosa and narrow site were dynamically observed, Micro-trepan was used to relief obstruction,and then the retrograde operation of silicone implantation was taken, Silicone duct was taken out 1 month to 3 months later, Lacrimal patency was observed under lacrimal endoscopy for 6 months following up.Results Fifty-nine eyes were cured（95.1%）,2 eyes were improved（3.2%） and 1 eye was ineffective（1.6%） in all cases treated with micro-trepan combined with silicone implantation under lacrimal duct endoscopy.Conclusion Lacrimal duct endoscope can be used to observe tiny pathological changes in lacrimal duct.Micro-trepan can avoid the formation of false passage and damage to normal tissue under lacrimal duct endoscopy,which can directly operate at narrow or obstructed lacrimal duct,restore the physiological structure of nasolacrimal duct.Micro-trepan combined with sillcone implantation and observing under lacrimal duct endoscopy is an ideal method for treatment.

关 键 词：内窥镜 鼻泪管阻塞 微型环钻 

分 类 号：R777.22[医药卫生—眼科]