Medpor泪道义管植入术治疗难治性泪道阻塞的临床分析  

Clinical analysis of Medpor coated tear drainage tube implantation for refractory lacrimal duct obstruction

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,湖北武汉430063

出　　处：《中国实用眼科杂志》2016年第1期73-77,共5页Chinese Journal of Practical Ophthalmology

基　　金：爱尔眼科医院集团科研基金资助项目（AF145D13）

摘　　要：目的探讨Medpor泪道义管植入术治疗难治性泪道阻塞的有效性和安全性，指导临床应用。方法于2010年3月至2015年3月在武汉爱尔眼科医院就诊的55例难治性泪道阻塞患者作为研究对象，对其中46例泪囊存在患者行鼻内镜下结膜囊泪囊鼻腔吻合联合Medpor泪道义管植入术，对另外9例无泪囊患者行单纯Medpor泪道义管植入术。术后随访3～60个月，通过临床资料收集、门诊随访和电话随访相结合的方法，记录患者泪道阻塞类型及手术方式，观察手术效果和并发症情况，对数据结果进行分析，评价Medpor泪道义管植入术的临床意义。结果51例（92．7％）患者无溢泪症状或溢泪症状明显改善，义管管内冲洗通畅。术后并发症包括：义管上下口肉芽组织增生9例（16．4％），异物不适感8例（14．5％），义管管腔被分泌物阻塞5例（9．1％），义管长度不当2例（3．6％），义管反复移位2例（3．6％）。结论Medpor泪道义管植入术可有效治疗难治性泪道阻塞。手术方法成功率高，并发症少，安全有效，值得临床推广。Objective To investigate the effectiveness and safety of Medpor coated tear drainage tube implantation for refractory lacrimal duct obstruction, in order to guide the clinical application. Methods Fifty-five cases of refractory lacrimal duct obstruction patients were selected as the research subjects, among which, 46 cases of patients with in the presence of lacrimal sac were treated by endoscopic endonasal conjunctivodacryocystorhinostomy with Medpor coated tear drainage tube implantation, 9 cases of patients without lacrimal sac were treated by simple Medpor coated tear drainage tube implantation. With 3 to 60 months of post-operation follow-up, types of lacrimal duct obstruction and operative means were recorded through the collection of clinical data, out-patient follow-up and telephone follow-up, and the operation effect and complications were observed. Meanwhile, the data result was analyzed, for evaluating the clinical significance of Medpor coated tear drainage tube implantation. Results Complete success and significant improvement of epiphora was achieved in 51 cases （92.7%）, with irrigation of saline solution in the tube fluently. The post-operation complications included： granulation tissue proliferation of the opening of tube： 9 cases （16.4%）, foreign body sensation 8 cases （14.5%）, the tube was blocked by secreta 5 cases （9.1%）, improper tube length 2 cases （3.6%）, repeated malpositon of the tube 2 cases （3.6%）. Conclusions Medpor coated tear drainage tube implantation can treat the refractory lacrimal duct obstruction. This operation method is characterized by high success rate, less complications, safety and efficiency, and it is worth clinical promotion.

关 键 词：Medpor泪道义管植入 泪道阻塞 结膜囊泪囊鼻腔吻合术 

分 类 号：R777.2[医药卫生—眼科]