鼻内镜下泪总管开放术治疗泪囊吻合口闭锁的临床分析  

Clinical analysis of endoscopic common canaliculus opening operation for lacrimal sac anastomotic occlusion

作　　者：谢杨杨[1] 杜欢[1] 张昌琴 张将[1] 

机构地区：[1]武汉爱尔眼科医院,中国湖北省武汉市430063

出　　处：《国际眼科杂志》2016年第1期171-173,共3页International Eye Science

摘　　要：目的：探讨鼻内镜下泪总管开放术治疗泪囊吻合口闭锁的有效性和安全性,指导临床应用。方法：回顾性临床研究。选取泪囊吻合口闭锁患者66例70眼作为研究对象,施行鼻内镜下泪总管开放术。术后随访3~24mo,通过临床资料收集、门诊随访和电话随访相结合的方法,记录患者术后主观感受,观察手术效果和并发症情况,以及处理并发症后的效果,对数据结果进行分析,评价鼻内镜下泪总管开放术的临床意义。结果：溢泪症状完全缓解或显著改善68眼（97%）,泪道冲洗通畅且无返流。术后并发症包括：内眦部异物不适感51眼（73%）,鼻腔内偶伴异物不适感22眼（31%）,泪总管开口周围肉芽组织增生4眼（6%）,球结膜局限性充血16眼（23%）,泪道引流管脱出3眼（4%）。结论：鼻内镜下泪总管开放术可有效治疗泪囊吻合口闭锁。该手术方法成功率高、并发症少、安全有效、值得临床推广。AIM：To investigate the effect and safety of endoscopic common canaliculus opening operation for lacrimal sac anastomotic occlusion, in order to guide the clinical application.METHODS：Retrospective clinical study. Sixty-six patients（70 eyes）with lacrimal sac anastomotic occlusion were selected as the research subjects. All patients were treated by endoscopic common canaliculus opening operation. The post-operation follow-up lasted for 3～24mo. Subjective feelings of patients were recorded through the collection of clinical data, out-patient follow-up and telephone follow-up. The operation effect and complications were observed, as well as the effect of treatment on complications. Meanwhile, the data was analyzed for evaluating the clinical efficacy of endoscopic common canaliculus opening operation. RESULTS：Epiphora was disappeared or obviously improved in 68 eyes（97%）, with lacrimal irrigating fluently and no obstacle. The post-operative complications included：51 eyes（73%）with foreign body sensation in inner canthus, 22 eyes（31%）with foreign body sensation in the nose occasionally, 4 eyes（6%）with granulation tissue proliferation at the opening of common canaliculus, 16 eyes（23%）with localized congestion of the bulbar conjunctiva, and 3 eyes（4%）with lacrimal drainage tube out. CONCLUSION： Endoscopic common canaliculus opening operation can treat the lacrimal sac anastomotic occlusion. This operation is characterized by high success rate, less complications, safe and efficient, and it is worth clinical promotion.

关 键 词：泪总管开放术 鼻内镜 泪囊吻合口闭锁 泪道引流管 并发症 

分 类 号：R779.6[医药卫生—眼科]