逆行挤压排石联合泪道置管术治疗慢性泪小管炎的疗效分析  

Experience in treatment of chronic lacrimal canaliculitis with retrograde squeeze to remove stones combined with lacrimal tube implantation

作　　者：潘淑玲 陈岩 PAN Shu-ling;CHEN Yan(Department of Eye Plastic and Lacrimal Disease, Shanghai Aier Eye Hospital, Shanghai 200336, China)

机构地区：[1]上海爱尔眼科医院眼整形泪道科,上海200336

出　　处：《中国临床新医学》2021年第5期477-480,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的分析逆行挤压排石联合泪道置管术治疗慢性泪小管炎的疗效。方法回顾性分析2018-06~2020-12于该院就诊的35例(35眼)慢性泪小管炎患者,其中上泪小管炎10例,下泪小管炎25例,均不合并慢性泪囊炎,记录其临床症状及体征。所有患者均于局麻下接受逆行挤压排石联合泪道置管术治疗,术后3 d连续予以抗生素滴眼液冲洗泪道及结膜囊,术后1个月予以拔管处理。术后1周、1个月、3个月,记录各时间段术眼脓液改善情况、泪小管形态、泪道冲洗结果。结果35例患者经治疗后均顺利出院,无并发症发生。术后3个月35例患者溢泪溢脓症状均消失;泪小管形态30眼正常化,3眼扩张肥厚,2眼不全阻塞;泪道冲洗30眼通畅,5眼欠通畅。临床治愈率为85.71%。结论逆行挤压排石联合泪道置管术治疗慢性泪小管炎效果确切,可有效解决流脓症状且对泪道损伤小。但术前需掌握好适应证,术中需尽量排尽结石,置管时避免损伤泪小管黏膜,术后需加强泪道及结膜囊敏感抗菌药物的应用。Objective To analyze the effect of retrograde squeeze to remove stones combined with lacrimal tube implantation on chronic lacrimal canaliculitis.Methods A retrospective analysis was performed on 35 patients(35 eyes)with chronic lacrimal canaliculitis who were treated at Shanghai Aier Eye Hospital from June 2018 to December 2020,including 10 cases of upper canaliculitis and 25 cases of lower canaliculitis.None of them was complicated with chronic dacryocystitis.The clinical symptoms and signs of all the patients were recorded.All the patients underwent retrograde squeeze to remove stones combined with lacrimal tube implantation under local anesthesia.Antibiotic eye drops were continuously given to the patients to flush the lacrimal duct and conjunctival sac for three days after operation.The silicone tube was removed one month after surgery.One week,one month and three months after operation,the improvement of pus in the operated eyes,the morphology of lacrimal canaliculi and the results of lacrimal irrigation were recorded in each time period.Results After treatment,35 patients were discharged without complications.The symptoms of epiphora and pyorrhea disappeared in the 35 patients 3 months after operation.The morphological observation of lacrimal canaliculi showed that 30 eyes were normal,and 3 eyes were dilated and hypertrophic,and 2 eyes were incomplete obstruction.The results of lacrimal irrigation showed that 30 eyes were passable,and 5 eyes were not completely passable.The clinical cure rate was 85.71%.Conclusion Retrograde squeeze to remove stones combined with lacrimal tube implantation is effective in treatment of chronic canaliculitis.It can effectively solve the symptoms of pyorrhea and has little damage to the lacrimal passage.However,it is necessary to master the indications before operation,to remove the stones as many as possible during the operation,to avoid damaging the mucosa of lacrimal canaliculi during the intubation,and to strengthen the application of sensitive antibiotics for lacrimal du

关 键 词：慢性泪小管炎 泪道置管 结石 

分 类 号：R777.2[医药卫生—眼科]