鼻内镜下鼻腔泪囊吻合失败原因分析及预防措施  

The Analysis of Failure Reasons and Prevention Measures for Transnasal Endoscopic Dacryocystorhinostomy

作　　者：王庆 刘小琴 

机构地区：[1]中国五冶集团有限公司医院,四川成都610053

出　　处：《中外医学研究》2016年第27期122-123,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析探讨鼻内镜下鼻腔泪囊吻合失败的原因及防治措施。方法:对2010年5月-2013年10月笔者所在科室收治的39例42眼慢性泪囊炎进行了鼻内镜下鼻腔泪囊吻合病例的临床资料进行回顾性分析。结果:患者中2例2眼发现小泪囊,切开泪囊后壁无法翻转后完全覆盖骨窗;1例1眼术后24 h内鼻腔活动性出血,以凡士林纱条填塞压迫止血。术后28例31眼溢泪、溢脓症状完全消失,泪道冲洗通畅;8例8眼溢泪、溢脓症状减轻,泪道冲洗不畅,加压后冲洗泪道通畅;3例3眼泪道冲洗不通畅,未见脓性分泌物。结论:影响鼻内镜下鼻腔泪囊吻合的因素较多,正确掌握手术适应证,鼻内窥镜下开放大小合适的骨窗、严密的止血以及充分的麻醉、优良的心理疏导是提高鼻内窥镜下鼻腔泪囊吻合成功的关键环节。Objective：To evaluate the causes of failure in transnasal endoscopic dacryocystorhinostomy,and to suggest preventive measures.Method：The clinical data of 39 patients（42 eyes） with chronic dacryocystitis who underwent transnasal endoscopic dacryocystorhinostomy in our department were analyzed retrospectively.Result：Small lacrimal sac was found in 2 patients（2 eyes）,cut open the lacrimal sac wall couldn＇t completely cover the bone window.Active bleeding occured within 24 hours after surgery in 1 patient（1 eye）,Vaseline gauze tamponade was used to hemostasis.Twenty eight patients（31 eyes） were free of their symptoms and kept stoma patency.Eight patients＇（eight eyes） tears spill overflow pus symptoms relieved,lacrimal duct flushing was not free,after compression it was free.Three patients（3 eyes） were not kept stoma patency but no discharge of pus.Conclusion：There are many influence factors of nasal endoscopic nasal lacrimal sac anastomosis.Choosing right patient,appropriate size bone window,effective hemostasis,anesthesia and psychological counseling is benefit to gain good clinical effects of dacryocystorhinostomy.

关 键 词：鼻腔内窥镜 慢性泪囊炎 治疗失败 

分 类 号：R779.6[医药卫生—眼科]