人工鼻泪管植入术后并发症的分析研究  

Analysis of postoperative complications of artificial nasolacrimal duct implantation

作　　者：杨俭伟[1] 李妍[1] 武群英[1] 肖丽[1] 白萍[1] 

机构地区：[1]河北省眼病治疗中心邢台市眼科医院,中国河北省邢台市054001

出　　处：《国际眼科杂志》2012年第4期728-729,共2页International Eye Science

摘　　要：目的:探讨人工鼻泪管植入术后并发症发生的原因,寻找有效的处理方法。方法:对我院2009-05/2010-10行人工鼻泪管植入3mo以上的泪囊炎及鼻泪管阻塞患者146例160眼进行回顾性分析,总结分析手术后并发症发生原因,观察并发症处理的方法和效果。结果:患者146例160眼中共37眼发生并发症,3眼(8.1%)因眉弓过高、泪囊-鼻泪管夹角太大;3眼(8.1%)因外伤性泪囊炎鼻泪管狭窄,扩张器不能进入鼻泪管而改行手术治疗;5眼(13.5%)在1mo后出现人工鼻泪管下滑移位行再次植入;20眼(54.1%)术后6mo发生肉芽组织增生和阻塞;6眼(16.2%)术后12mo发生肉芽组织增生和阻塞。经扩张后注入丝裂霉素C与妥布霉素地塞米松眼膏5眼恢复通畅,失败病例行泪囊鼻腔吻合术或经鼻泪囊开窗引流术。结论:人工鼻泪管蘑菇头部位肉芽组织增生造成阻塞是人工鼻泪管植入最常见并发症,发生率与植入时间成正比,人工鼻泪管植入要严格掌握适应证,慢性泪囊炎的治疗应以手术治疗为首选方法。AIM：To investigate the postoperative complications of artificial nasolacrimal duct implantation,and to look for effective treatment method.METHODS：Totally 146 cases（160 eyes） of dacryocystitis and nasolacrimal duct obstruction with more than 3 months of artificial nasolacrimal duct implantation in our hospital during 2009-2010 were analyzed retrospectively.The causes of complications were summarized and analyzed,treatment method and its effect on complication were observed.RESULTS：Complications occurred in 37 eyes of the 160 eyes.3 eyes（8.1%） were due to eyebrow was too high and lacrimal sac-nasolacrimal duct angle was too big.3 eyes（8.1%） with traumatic dacryocystitis and nasolacrimal duct stenosis changed to operation treatment because the dilator could not enter the nasolacrimal duct;5 eyes（13.5%） underwent reimplantation due to artificial nasolacrimal duct down shift at one month later;Proliferation of granulation tissue and obstruction occurred in 20 eyes（54.1%） 6 months after the surgery,and 6 eyes（16.2%） 12 months after the surgery;5 eyes restored unobstructed with dilatation and injection of mitomycin C and tobramycin dexamethasone ointment,the failed cases underwent dacryocystorhinostomy or nasal endoscopic dacryocystorhinostomy.CONCLUSION：Obstruction caused by granulation tissue hyperplasia of artificial nasolacrimal duct mushroom head is the most common complication of artificial nasolacrimal duct implantation,incidence is proportional to implantation time.It is needed to strictly grasp the indications of artificial nasolacrimal duct implantation.Chronic dacryocystitis should be treated with operation therapy as the preferred method.

关 键 词：人工鼻泪管 泪囊炎 鼻泪管阻塞 并发症 

分 类 号：R779.6[医药卫生—眼科]