鼻内窥镜下泪囊鼻腔吻合置管术治疗人工鼻泪管取出后复发性泪囊炎  

Treatment of dacryocystorhinostomy and intubation under nasal endoscope on recurrent dacryocystitis after removal of artificial nasolacrimal duct

作　　者：张懿[1] 杨华[1] 杨晓钊[1] 郑璇[1] Yi Zhang;Hua Yang;Xiao-Zhao Yang;Xuan Zheng(Department of Ophthalmology, Xi'an No.1 Hospital, Shaanxi Institute of Ophthalmology, Shaanxi Key Laboratory of Ophthalmology, Clinical Research Center for Ophthalmology Diseases of Shaanxi Province, Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi'an 710002, Shaanxi Province, China)

机构地区：[1]中国陕西省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眼科,710002

出　　处：《国际眼科杂志》2022年第2期331-335,共5页International Eye Science

基　　金：陕西省社会发展科技攻关项目(No.2016SF-328);西安市科技计划项目(No.2019115913YX014SF047)。

摘　　要：目的:探讨人工鼻泪管取出后复发性泪囊炎泪囊大小的比例分布情况及鼻内窥镜下泪囊鼻腔吻合置管术治疗人工鼻泪管取出后复发性泪囊炎的临床疗效。方法:回顾性研究。2018-01/2019-11于我院眼科就诊的人工鼻泪管取出后复发性泪囊炎患者73例73眼,收住院后均行泪囊造影测量泪囊大小,并于全身麻醉下行鼻内窥镜下泪囊鼻腔吻合置管术,分析术后2wk,1、3、6mo造瘘口面积及有效率。结果:纳入患者中大泪囊(横径>5mm)者13眼(18%),中泪囊(横径2~5mm)者26眼(36%),小泪囊(横径<2mm)者34眼(47%)。术后2wk,1、3、6mo泪囊造瘘口面积有差异(P<0.05);术后6mo造瘘口面积较术后2wk,1、3mo分别显著减少了14.08±0.68、10.49±0.75、0.31±0.23mm2(均P<0.05);术后2wk,1、3、6mo有效率分别为100%、93%、88%、85%。结论:人工鼻泪管取出后复发性泪囊炎泪囊大小以中、小泪囊为多,鼻内窥镜下泪囊鼻腔吻合置管术治疗人工鼻泪管取出后复发性泪囊炎疗效肯定。AIM:To investigate the proportional distribution of the size of lacrimal sac in recurrent dacryocystitis after the removal of artificial nasolacrimal duct and the clinical effect of dacryocystorhinostomy under nasal endoscope on patients with recurrent dacryocystitis.METHODS:Totally 73 patients(73 eyes)with recurrent dacryocystitis after removal of artificial nasolacrimal duct in our hospital from January 2018 to November 2019 were retrospectively studied.All patients underwent dacryocystography after hospitalization,and then performed dacryocystorhinostomy combined with intubation of double-artificial nasolacrimal duct under nasal endoscope and general anesthesia.The size of lacrimal sac was measured,and the area and effective rate of fistula were analyzed respectively at 2wk,1,3 and 6mo after operation.RESULTS:There were 13 eyes with large dacryocyst(Transverse diameter>5mm,18%),26 eyes with middle dacryocyst(Transverse diameter between 2-5mm,36%),and 34 eyes with small dacryocyst(Transverse diameter<2mm,47%);There was significant difference in the stoma area of dacryocystostomy at 2wk,1,3,6mo respectively(P<0.05);Compared with 2wk,1,3mo after operation,the stoma area at 6mo after operation significantly decreased by 14.08±0.68,10.49±0.75,0.31±0.23mm2(all P<0.05);The curative rates were 100%,93%,88%and 85%at 2wk,1,3,6mo after operation,respectively.CONCLUSION:After the removal of the artificial nasolacrimal duct,the majority of the patients with recurrent dacryocystitis typically featured medium and small lacrimal sac.The curative effect of this type of recurrent dacryocystitis by dacryocystorhinostomy and intubation under nasal endoscope was proved to be effective,which could serve as a proper and better choice in clinic practice.

关 键 词：鼻内窥镜 泪囊鼻腔吻合术 双泪小管置入式人工泪管 复发性泪囊炎 

分 类 号：R779.6[医药卫生—眼科]