鼻泪管支架治疗鼻泪管阻塞疾病的疗效观察  

Clinical observation of nasolacrimal duct stent in the treatment of nasolacrimal duct obstruction disease

作　　者：陈建华[1] 陈伟[2] 丛晨阳[2] 毕宏生[3] 

机构地区：[1]山东中医药大学,济南250002 [2]山东中医药大学附属眼科医院 [3]山东中医药大学眼科研究所

出　　处：《中国实用眼科杂志》2015年第2期180-182,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的评价鼻泪管支架植入术治疗鼻泪管阻塞性疾病的临床疗效。方法对2009年12月至2013年12月在山东中医药大学附属眼科医院经回顾性分析鼻泪管阻塞性疾病患者89例103只眼的临床资料，其中慢性泪囊炎77例88只眼，单纯鼻泪管阻塞12例15只眼。自下鼻道逆行扩张鼻泪管成功后植入鼻泪管支架，术后7d内每天冲洗泪道，局部滴用含激素的抗生素滴眼液，术后1个月内每周冲洗泪道，术后6个月内每月冲洗泪道。结果随访6～36个月，76例88只眼获得成功，术后溢脓症状消失，溢泪症状改善有效率85．4％（88／103）。3例3只眼因骨性鼻泪管畸形无法逆行扩张鼻泪管而未能植入鼻泪管支架，改行鼻腔泪囊吻合术。3例3只眼术后2~3个月泪总管阻塞致流泪症状复发，6例8只眼术后6个月内、1例1只眼术后26个月鼻泪管支架出现阻塞，经泪道空芯探针反复疏通，同时给予0．4％庆大霉素＋0．1％地塞米松混合液冲洗泪道，滴用含激素的抗生素滴眼液后治愈。结论鼻泪管支架植入术治疗鼻泪管阻塞性疾病，具有手术无切口，术后面部不留瘢痕，保留泪道解剖位置，具有可重复性，操作简单、安全、微创、省时等优点。通过提高手术技巧、加强术后泪道护理，可明显提高治愈率，推动鼻泪管支架在临床的应用。Objective To evaluate the clinical efficacy of nasolacrimal duct stent in the treat- ment of nasolacrimal duct obstruction diseases. Methods The clinical data about 89 patients （103 eyes） with nasolacrimal duct obstruction disease were retrospectively analyzed, including 77 cases （88 eyes） of chronic dacryocystitis and 12 cases （15 eyes） of simple nasolacrimal duct obstruction. Nasolacrimal duct stents were implanted from the inferior nasal meatus after retrograde expansion of the nasolacrimal duct. Irrigate the lacrimal everyday within 7 days after surgery and drop antibiotic drops containing hormones. Irrigate the lacrimal every week within one month and every month with- in six months. Results Followed up to 6-36 months, 76 cases （88 eyes） were succeed. Surgical suc- cess was defined by symptomatic relief of epiphora and pus overflow. Because of nasolacrimal duct bone deformity, 3 cases （3 eyes） could not be retrograde dilated and failed nasolacrimal duct stent implantation, and then diverted dacryocystorhinostomy. Epiphora occurred in 3 cases （3 eyes） because of lacrimal duct obstruction. Nasolacrimal duct stent blocked within 6 months of 6 cases （8 eyes） and 26 months of 1 case （1 eye） after surgery. Conclusions The nasolacrimal duct stent can be used in the treatment of nasolacrimal duct obstruction disease, without surgical incision and scars, keeping lacrimal anatomical location. This treatment is simple, safe, minimal invasive and time-saving. It is important to improve surgical techniques and postoperative care which can signifi- cantly improve the cure rate and promote the clinical application of nasolacrimal duct stents.

关 键 词：鼻泪管阻塞 鼻泪管支架 

分 类 号：R777.220.5[医药卫生—眼科]