黏膜瓣泪小点成形术治疗慢性泪小管炎的疗效  

Efficacy of mucosal flap punctoplasty in the treatment of chronic canaliculitis

作　　者：黄伟锋 陈荣新[1] 赵静 李星仪[1] 姜爱新[2] 曹淑娟[2] 于欣悦 梁轩伟[1] HUANG Weifeng;CHEN Rongxin;ZHAO Jing;LI Xingyi;JIANG Aixin;CAO Shujuan;YU Xinyue;LIANG Xuanwei(State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science,Guangdong Provincial Clinical Research Center for Ocular Diseases,Guangzhou 510060;Ophthalmic Center of the First People’s Hospital of Kashgar Area,Kashgar Xinjiang 844000,China)

机构地区：[1]中山大学中山眼科中心,眼科学国家重点实验室,广东省眼科视觉科学重点实验室,广东省眼部疾病临床医学研究中心,广州510060 [2]喀什地区第一人民医院眼科中心,新疆喀什844000

出　　处：《眼科学报》2021年第11期881-887,共7页Eye Science

基　　金：广东省基础与应用基础研究基金自然科学基金项目(2021A1515012043);眼科学国家重点实验室专项经费(30306020240020219);新疆维吾尔自治区创新环境(人才、基地)建设专项(天山青年计划)(2019Q145);喀什地区第一人民医院“珠江学者•天山英才”合作专家工作室创新团队(KDYY202018)。

摘　　要：目的:观察黏膜瓣泪小点成形术用于治疗慢性泪小管炎的疗效。方法:回顾性病例系列研究。收集2018年1月至2020年12月中山眼科中心眼整形科就诊的44例慢性泪小管炎患者的临床资料,分析其性别、年龄、患病眼别、临床症状、泪道冲洗结果等临床特点。采用黏膜瓣泪小点成形术进行治疗,术后随访评估其疗效。结果:44例慢性泪小管炎患者以女性为主(男女比例1:3.9),单侧发病,多累及下泪小管(上下泪小管比例1:3),主要表现为分泌物增多、溢泪以及内眦部位红肿,结石阳性率为95.7%,病原微生物检查结果显示以放线菌感染为主(78.3%)。大部分患者术后1周内症状得到明显改善,其中1例上下泪小管炎患者于术后2个月出现上泪小管炎复发。总体治愈率为97.8%,随访时间为(20.7±10.9)个月。结论:黏膜瓣泪小点成形术治疗慢性泪小管炎的临床疗效确切,方法可靠。Objective:To evaluate the efficacy of mucosal flap punctoplasty in patients with chronic canaliculitis.Methods:In this retrospective serial case study,the clinical data of 44 patients with chronic canaliculitis were collected from the Oculoplastic Department of Zhongshan Ophthalmic Center at Sun Yat-sen University between January 2018 and December 2020.Demographic data such as gender,age,affected eye,clinical presentations and lacrimal duct irrigation results were analyzed.The efficacy of the procedure,symptom resolution and complications were assessed.Results:Of the 44 patients,most(male:female 1:3.9)were female,and the disease most often(upper:lower 1:3)involved the lower lacrimal canaliculus of only one eye.Main symptoms included increased secretion,tearing,and swelling of the inner canthus.Stones were present in 95.7%of patients and Actinomyces israelli was found to be the most common pathogen(78.3%).Most patients’symptoms improved significantly within 1 week after surgery.Only one patient,who had infections in both the upper and lower canaliculi,had recurrence of upper canaliculitis 2 months after the surgery.The overall cure rate was 97.8%,and the follow-up time was(20.7±10.9)months.Conclusion:Mucosal flap punctoplasty is an efficacious and reliable method in the treatment of chronic canaliculitis.

关 键 词：泪小管炎 泪小点成形术 泪小管结石 泪器 

分 类 号：R779.6[医药卫生—眼科]