非内窥镜下Crawford管置管术治疗160例泪道阻塞  

Clinical Analysis of 160 Cases of Lacrimal Duct Obstruction Treated by Crawford Tube Catheterization Independent of Nasal Endoscopy

作　　者：李道远 冯秉民 刘兴德[1] LI Daoyuan;FENG Bingmin;LIU Xingde(Department of Ophthalmology, Guizhou Medical University, Guiyang 550004, Guizhou, China)

机构地区：[1]贵州医科大学眼科学教研室

出　　处：《贵州医科大学学报》2019年第8期936-939,954,共5页Journal of Guizhou Medical University

基　　金：国家自然科学基金项目(31760294);贵州省科技合作计划项目[黔科合LH字(2015)7388];贵州省教育厅科技人才成长项目[黔教合KY字(2018)186];贵州医科大学2018年度学术新苗培养及创新探索专项项目[黔科合平台人才(2018)5779-28];贵州省科技厅科技平台及人才团队计划[黔科合平台人才(2018)5608];贵州省科学技术基金计划[黔科合基础(2016)1120]

摘　　要：目的:观察非内窥镜下Crawford管置管术治疗泪道阻塞的临床效果。方法:160例(180眼)泪道阻塞性患者,采用非内窥镜下Crawford管置管术进行治疗,患者拔管后随诊3个月,比较不同发病部位(泪点膜闭、泪小管阻塞、泪总管阻塞、泪囊黏液囊肿及鼻泪管阻塞)、不同发病时间(≤2年、>2年)及不同发病年龄(≤40岁、>40岁)患眼的治疗效果。结果:180眼中治愈130眼(72.22%),好转23眼(12.78%),无效19眼(10.56%),复发8眼(4.44%);泪小点膜闭、泪小管阻塞、泪总管阻塞的治愈率显著高于泪囊黏液和鼻泪管阻塞患者(P<0.05),短病史组患眼的治愈率显著高于长病史组(P=0.001),年龄对治疗效果无影响(P=0.771);满意度调查发现63.7%以上患者对置管治疗后眼外观、舒适性、自觉症状及生活质量的提高等方面均比较满意。结论:非内窥镜下Crawford管置管术是一种治疗泪小管阻塞的有效方法。Objective: To analyze the effect of lacrimal duct obstruction through Crawford tube catheterization independent of nasal endoscopy. Methods: 160 casespatients (180 eyes) with lacrimal duct obstruction were treated with Crawford tube catheterization independent of nasal endoscopy.Follow-up for three months,comparing the location of lacrimal duct obstruction (lacrimal canaliculi closure,lacrimal canaliculi obstruction,lacrimal duct obstruction,dacryocyst mucocele and nasolacrimal duct obstruction),time of onset (≤2 years,>2 years) and efficacy in different age of onset. Results: Among 180 eyes,130 eyes were successfully cured (72.22%),23 eyes were improved (12.78%),19 eyes were ineffective (10.56%),eight eyes relapsed (4.44%).Additionally,patients with lacrimal canaliculi closure,lacrimal canaliculi obstruction,lacrimal duct obstruction showed higher cure rate than dacryocyst mucocele and nasolacrimal duct obstruction ( P <0.05).Short term disease group cure rate was higher than that of long term group ( P =0.001);age showed no influence on treatment efficacy ( P =0.771);satisfaction survey indicated that over 63.7% patients were satisfied with out-appearance, comfortableness,subjective symptom and improved life quality after surgery. Conclusion: Crawford tube catheterization independent of nasal endoscopy is an effective method for the treatment of lacrimal canaliculi obstruction.

关 键 词：crawford管 泪道阻塞 微创 非内窥镜 鼻泪道阻塞 泪囊黏液囊肿 

分 类 号：R77[医药卫生—眼科]