改良Ritleng泪道导管治疗泪道阻塞的临床观察  

Modified ritleng intubation system for treatment of lacrimal duct obstruction

作　　者：郭继虎[1] 肖扬[1] 王育红[1] 高敏[1] 牛改玲[1] 

机构地区：[1]首都医科大学附属北京朝阳医院西区眼科,北京100043

出　　处：《眼外伤职业眼病杂志》2010年第8期570-574,共5页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的描述对Ritleng泪道导管系统原有设计进行改良的可行性，并评价其疗效。方法采用镍钛形态记忆导丝等对Ritleng泪道导管进行改良，并应用于25例（26眼）严重阻塞性溢泪（Munk分级法，3～4级）。进行泪道诊断试验，随访评估泪道解剖及功能性开放。观察镍钛导丝引出鼻腔的方式。随意选择2例（2眼）进行计算机断层扫描泪道造影（ computed tomography-dacryocystography, CT-DCG）。结果拔管后随访4～12月，平均（7．1±3．7）月。拔管后末次随访，24眼（92．31％）溢泪症状完全消失。在经52个泪点的52次镍钛导丝导引操作中，46次（88．46％）镍钛导丝自动弹出鼻孔或进入鼻前庭。CT—DCG显示导管内造影剂充盈均匀、管腔开放。结论改良的导管系统，操作简便，有较高的泪道再涌室．Objective To describe the technical properties of the modified Ritleng intubation system and to verify its clinical effectiveness for lacrimal duct obstruction. Methods Nickel-titanium thread guide was adopted to modify the original Ritleng intubation system. The modified stents were successfully intubated in 26 eyes of 25 patients with severe obstructive epiphora （grade 3 or worse on Munk＇s scale）. Diagnostic tests were conducted to identify the anatomical and functional patency of the lacrimal duct. We recorded how the nickel-titanium thread guides extruded from the nostrils. 2 cases were randomly selected for computed tomographydacryocystography （CT-DCG）. Results The follow-up periods after extubation ranged from 4 months to 12 months （mean follow-up, 7.1± 3.7 months）. At the last follow-up after extubation, complete resolution of epiphora was achieved in 24 eyes （92.31%）. In 46 （ 88.46% ） of 52 intubation procedures through 52 individual punctae, the nickel-titanium thread guides spontaneously emerged out of the nostrils or in the nasal fossae. CT-DCG demonstrated thatthe lumens of the stents were patent and evenly filled with contrast media. Conclusion The modified intubation set was technically easy to be maneuvered with a favorable rate of recanalization.

关 键 词：泪道狭窄 泪道阻塞 Ritleng泪道导管 计算机断层扫描泪道造影 镍钛形态记忆合金 

分 类 号：R777.21[医药卫生—眼科]