35例先天性泪管瘘的疗效观察  

Clinical observation of 35 cases of congenital tears fistula

作　　者：黎小军[1] 田蔓男[1] 丁锐 李文捷[1] 魏志诚[1] 

机构地区：[1]兰州大学第一医院眼科,730000

出　　处：《中国斜视与小儿眼科杂志》2017年第3期38-40,共3页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的通过回顾性研究先天性泪管瘘的综合治疗方法,观察其有效性和安全性。方法根据泪道冲洗结果及手术方式将35例先天性泪管瘘患者分为3组,A组为通畅并行单纯瘘口切除术者13例;B组为通畅并行瘘口切除+泪道再通术者15例;C组为不通畅行瘘口切除+泪道再通术者7例。结果本次入组的病例共计35例,所有患者都表现为瘘口流泪,C组患者合并眼部流泪症状。A组、B组、C组术后瘘口溢泪均消失,但泪道冲洗A组通畅13例,B组通畅13例,C组通畅5例。A、B组对比差异有显著性(P<0.05);B、C组相比差异有显著性(P<0.05)结论大多数先天性泪管瘘可通过行单纯的瘘管摘除术治愈,对于不伴有泪液引流异常的患者行单纯瘘管切除,而不需联合鼻腔泪囊吻合术或置管治疗,具有安全性,手术痛苦小,价格低的优势;而对于合并有泪液引流异常的患者则需要同时行泪道再通手术。Objective To evaluate the efifcacy and safety of the combined treatment of congenital tears ifstula by retrospective study.Methods 35 cases of congenital tear ifstula were divided into 3 groups according to the results of lacrimal irrigation and operation. Group A was 13 cases of simple ifstulectomy. Group B was smooth and parallel ifstula resection and lacrimal passage recanalization 15 cases , 7 cases in group C were treated with ifstula resection and lacrimal passage reoperation.Results There were 35 cases in this group. All patients presented with ifstula tearing, and group C with eye tears. In group A, B and C, ifstula eruption disappeared, but in group A, 13 cases were unobstructed, group B was unobstructed in 13 cases and group C was unobstructed in 5 cases. There was significant difference between group A and B（P〈0.05）. There was significant difference between group B and C （P〈0.05） .Conclusions Most congenital lacrimal fistula can be cured by simple fistula excision.For patients without tear drainage abnormalities in patients with simple ifstula, without the need for nasal dacryocystorhinostomy or catheterization treatment, with safety, surgical pain lower, the advantages of low price; and for the merger of patients with tear drainage abnormalities you need to simultaneously lacrimal pass recanalization.

关 键 词：先天性泪管瘘 手术治疗 泪液引流异常 临床观察 

分 类 号：R779.6[医药卫生—眼科]