泪小管炎行单纯泪小管切开与联合置管术疗效对比分析  

Comparative analysis the effect of canaliculitis with canalicular incision and joint lacrimal tube implantation

作　　者：李雪[1] 范瑞[1] 张军[1] 高丽涛[1] 金福录 

机构地区：[1]沈阳爱尔眼视光医院,沈阳110003

出　　处：《中国实用眼科杂志》2017年第5期518-520,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的对比泪小管炎行单纯泪小管切开和泪小管切开联合置管术患者的术后效果，探讨更有效、安全的治疗方案。方法回顾性病例系列研究。选取2010年5月至2015年11月在沈阳爱尔眼视光医院就诊的泪小管炎患者235例（235只眼），其中186例（186只眼）为上泪小管或下泪小管单独受累，49例（49只眼）为上、下泪小管同时受累。121例（121只眼）单纯行泪小管切开术，114例（114只眼）行泪小管切开联合泪道再通管置入术治疗。置管患者术后1个月取管。术后随访6个月~5年，观察泪小点形态、泪小管炎症情况、有无异常增生。结果235例（235只眼）均手术顺利。单纯行泪小管切开的患者中6例（6只眼）复发，复发率为5%，14例（14只眼）为泪小管炎合并泪小管阻塞、需进一步治疗，泪小点形态均良好；泪小管切开联合置泪道再通管的患者，无复发，2例（2只眼）出现泪小点息肉增生，发生率为1.8%，2例（2只眼）出现泪小点撕裂，发生率为1.8%。两组均未出现上、下泪小管粘连。结论泪小管炎行泪小管切开联合置管手术可减少术后的复发机率，尤对上、下泪小管均受累及泪小管同时存在狭窄的患者具有同期治疗作用，但置管过程中避免损伤泪小点，并应注意置入硅胶管的反应增生。ObjectiveTo compare the postoperative effect of canaliculitis with canalicular incision and canalicular incision joint lacrimal tube implantation, to explore more effective and safe treatment approach.MethodsA retrospective study of 235 cases （235 eyes） canaliculitis patients in our hospital from May 2010 to November 2015, of which 186 cases （186 eyes） were separately on small tube or tears involvement of lacrimal duct, 49 cases （49 eyes） as the upper and lower lacrimal tubular involvement at the same time; 121 cases （121 eyes） of pure canalicular incision, 114 cases （114 eyes） with canalicular incision joint placed a one-time treatment of lacrimal tubular tube recanalization 1 month postoperatively in patients with catheter tube. Postoperative follow-up was from 6 months to 5 years, lacrimal point form, canalicular inflammatory conditions, presence of abnormal growths were observed.ResultsOperations of 235 cases （235 eyes） were successfully. On the patients with canalicular incision only, 6 patients （6 eyes） had recurrence, the recurrence rate was 5%; 14 cases （14 eyes） had canaliculitis and at the same time with lacrimal tubular obstruction that needed further treatment; lacrimal point form were good. The patients received canalicular incision joint placed with one-time lacrimal tubular tube recanalization had no recurrence, 2 cases （2 eyes） with hyperplasia of lacrimal point polyps, the incidence was 1.8%, 2 cases （2 eyes） of lacrimal point tear, rate of 1.8%. Of 49 cases （49 eyes） after careful nursing did not occur the tears on tubular adhesion.ConclusionsCanalicular incision joint lacrimal tube implantation can reduce the recurrence of postoperative catheter surgery, especially for the upper and lower tubular involvement and lacrimal tubular both with narrow therapeutic effect, but in the process of the catheter lacrimal point, should pay attention to avoid injury and hyperplasia response to the silicone tube.

关 键 词：泪小管炎 泪小管切开 泪道置管 

分 类 号：R777.22[医药卫生—眼科]