鼻内镜引导下人工鼻泪管取出术的疗效观察  

Clinical observation on the therapeutic effect of artificial nasolacrimal duct extraction via nasal endoscope

作　　者：张懿[1] 杨华[1] 杨晓钊[1] 郑璇[1] Zhang Yi;Yang Hua;Yang Xiaozhao;Zheng Xuan(Department of Ophthalmology,Xi'an First Hospital,Shaanxi Institute of Ophthalmology,Shaanxi Key Laboratory of Ophthalmology,Clinical Research Center for Ophthalmology Diseases of Shaanxi Province,First Affiliated Hospital of Northwest University.Xi'an 710002,China)

机构地区：[1]西安市第一医院眼科,陕西省眼科研究所,陕西省眼科学重点实验室,陕西省眼科疾病临床医学研究中心,西北大学附属第一医院,710002

出　　处：《临床眼科杂志》2020年第4期365-367,共3页Journal of Clinical Ophthalmology

基　　金：陕西省科学技术研究发展计划项目(No.2016SF-328)。

摘　　要：目的探讨鼻内镜引导下人工鼻泪管取出术的临床疗效。方法收集2015年7月至2019年1月于我科就诊的经鼻内镜检查及泪囊造影检查明确诊断泪道人工鼻泪管置入术后(管存留)患者35例,收住院后在全麻下行鼻内镜引导下人工鼻泪管取出术,同时予以泪道探通并注入抗生素眼膏,术后随访3个月评价疗效。结果35例患者中,完整取出人工鼻泪管31例,随访后有24例流泪症状完全消失,3例流泪症状缓解,4例流泪症状无改善,总体有效率达77.1%。结论相对外路鼻腔泪囊吻合术(EX-DCR)或内路鼻腔泪囊吻合术(EN-DCR)联合泪道人工鼻泪管取出术,鼻内镜引导下人工鼻泪管取出术保留了泪道引流系统的完整性,操作相对简单,面部无瘢痕,术后恢复快,大部分患者有效,值得尝试。Objective To explore the clinical effect of artificial nasolacrimal duct extraction via nasal endoscope.Methods A total of 35 patients with definite diagnosis of postoperative artificial nasolacrimal duct placement(tube retention)who examined by transnasal endoscopy and dacryocystography in our department from July 2015 to January 2019 were enrolled.During hospitalization,the artificial nasolacrimal duct extractions were conducted via the guidance of nasal endoscope under general anesthesia.At the same time,the lacrimal canals were explored and injected with antibiotic eye ointment.The curative effects were evaluated after 3 months of follow-up.Results Among the 35 patients,artificial nasolacrimal ducts were completely removed in 31 patients.At follow-up,lacrimal symptoms completely disappeared in 24 patients,relieved in 3 patients,but not improved in 4 patients,the overall effective rate was 77.1%.Conclusions Compared to the external dacryocystorhinostomy(EX-DCR)or the endonasal dacryocystorhinostomy(EN-DCR)combined with the artificial nasolacrimal duct extraction,the advantages of artificial nasolacrimal duct extraction via nasal endoscope include integrity retention of the lacrimal duct drainage system,the relatively simple operation,no scar on the face and the quick recovery.This method is effective for most of the patients and thus worth trying.

关 键 词：鼻内镜 泪道人工鼻泪管 

分 类 号：R73[医药卫生—肿瘤]