鼻腔内窥镜辅助下鼻泪管支架植入治疗鼻泪管阻塞  

Nasolacrimal duct stent for nasolacrimal duct obstruction with nasal endoscope

作　　者：纪风涛[1] 李永蓉 宁进[1] 孙文娟[1] 

机构地区：[1]中国安徽省合肥市第二人民医院眼科,230000

出　　处：《国际眼科杂志》2016年第5期984-986,共3页International Eye Science

摘　　要：目的：观察鼻腔内窥镜辅助下鼻泪管支架植入治疗鼻泪管阻塞的疗效。方法：对36例40眼鼻泪管阻塞患者在鼻腔内窥镜辅助下行鼻泪管支架植入术,术后采用Munk评分评价泪溢程度,判断疗效,鼻泪管支架长期应用的成功率利用KaplanMeier分析进行生存评估,对不同类型的鼻泪管阻塞,利用log-rank检验比较其生存曲线。结果：一次手术成功率为97%,术后平均随访19mo,取得完整随访资料30例34眼,总体有效率71%,KaplanMeier生存曲线分析显示鼻泪管支架植入术后,术后总体平均通畅时间估计值为22.69±2.30mo,95%可信区间为18.18~27.19,生存曲线比较显示单纯鼻泪管阻塞术后再通率明显高于鼻泪管阻塞合并慢性泪囊炎的再通率,差异有统计学意义（P〈0.05）。结论：鼻腔内窥镜辅助下鼻泪管支架植入治疗鼻泪管阻塞安全、有效,单纯鼻泪管阻塞手术效果优于鼻泪管阻塞合并慢性泪囊炎。AIM ： To observe the curative effect of nasolacrimal duct obstruction treated by nasolacrimal duct stent assisted with nasal endoscope. METHODS： Thirty- six cases（ 40 eyes） with nasolacrimal duct obstruction were placed in nasolacrimal stent assisted with nasal endoscope. M unk J was used to evaluate the degree of epiphora. The percentage of stent patency during long- termfollowup was estimated by means of Kaplan- M eier analysis. Survival curves of the different etiology of obstruction were compared using log- rank test. RESULTS： The overall technical success rate of stent placement was 97%. During a mean 19 mo followup,30cases（ 34 eyes） were gotten completed case records. The total effective rate was 71%. Kaplan- M eier survival curves showed that the average overall patency time was estimated for 22. 69 ± 2. 30 mo,95% CI： 18. 18- 27. 19 mo.Treatment with lacrimal duct stent was more successful for nasolacrimal duct obstruction without dacryocystitis than for that with dacryocystitis（ P〈0. 05）. CONCLUSION： Nasolacrimal duct stent implantation assisted with nasal endoscope is a safe and effective method for nasolacrimal duct obstruction. The patency of idiopathic obstruction after treatment is better than that of nasolacrimal duct obstruction with chronic dacryocystitis.

关 键 词：鼻泪管支架 鼻泪管阻塞 鼻腔内窥镜 治疗 

分 类 号：R779.6[医药卫生—眼科]