鼻内镜下泪囊支架植入联合泪道置管术治疗慢性泪囊炎365例临床疗效分析  

Clinical analysis of 365 cases of chronic dacryocystitis treated by nasal endoscopic dacryocystal stent implantation combined with lacrimal duct catheterization

作　　者：郑扬菁 陈正勇 ZHENG Yangjing;CHEN Zhengyong(Department of Ophthalmology,Fuzhou Southeast Eye Hospital(Jinshan New Hospital),Fuzhou 350009,China)

机构地区：[1]福州东南眼科医院(金山新院)眼科,福建福州350009

出　　处：《中国现代医生》2022年第12期68-71,共4页China Modern Doctor

摘　　要：目的探讨鼻内镜下泪囊支架植入联合泪道置管术在慢性泪囊炎患者中的应用及疗效分析。方法回顾性分析2019年1月至2020年12月于福州东南眼科医院(金山新院)行手术治疗的365例慢性泪囊炎患者,术中先将泪囊情况分为大泪囊和小泪囊,均采用鼻内镜下泪囊支架植入联合泪道置管的手术方式,在鼻腔泪囊吻合口处植入泪囊支架,同时由上、下泪点植入R-S泪道引流管,从吻合口处伸出,术后2个月时将支架和引流管一并取出,再行3~6个月随访,观察术腔恢复及泪道通畅情况,并对比这种术式对大泪囊和小泪囊的治疗效果区别。结果219例患者术中见泪囊较大,泪囊壁薄,无肉芽增生,术后复查211例泪道引流通畅,8例术后复发,治愈率为96.35%;146例患者手术中见泪囊较小,泪囊壁厚,有肉芽增生,术后复查137例泪道引流通畅,9例术后复发,治愈率为93.84%,两组比较,差异无统计学意义(P>0.05)。结论慢性泪囊炎患者无论术前是否泪囊壁增厚及肉芽增生,采用鼻内镜下泪囊支架植入联合泪道置管术可提高总有效率,均超过90%;鼻内镜下泪囊支架植入联合泪道置管术对泪囊大小、泪囊壁的厚度及是否肉芽增生的治疗效果无明显区别。患者满意度高,临床应用范围更广,值得在临床中推广应用。Objective To investigate the application and efficacy analysis of lacrimal sac stent implantation combined with lacrimal duct placement under nasal endoscopy in patients with chronic dacryocystitis.Methods A retrospective analysis of 365 patients with chronic dacryocystitis who underwent surgical treatment in Fuzhou Southeast Eye Hospital(Jinshan New Hospital)from January 2019 to December 2020.During the operation,the lacrimal sac was divided into large and small lacrimal sacs,and both were intranasal The surgical method of lacrimal sac stent implantation combined with lacrimal duct placement.Lacrimal sac stent is implanted at the anastomosis of the nasal cavity and lacrimal sac,and R-S lacrimal drainage tube is implanted from the upper and lower punctum at the same time,extending from the anastomosis.At 2 months after the operation,the stent and drainage tube were taken out together,and then followed up for 3 to 6 months to observe the recovery of the operation cavity and the patency of the lacrimal duct,and compare the effect of this operation on the large and small lacrimal sacs.The difference in treatment effect.Results In 219 patients,the lacrimal sac was large,the wall of the lacrimal sac was thin,and there was no granulation hyperplasia.After the operation,211 cases had smooth lacrimal duct drainage,8 cases had recurrence after operation,and the cure rate was 96.35%;146 cases saw tears during the operation.The sac was small,the lacrimal sac wall was thick,and there was granulation hyperplasia.137 cases of lacrimal duct drainage were re-examined after operation,9 cases recurred after operation,and the cure rate was 93.84%,and there was no statistically significant difference between the two groups(P>0.05).Conclusion Patients with chronic dacryocystitis regardless of whether the lacrimal sac wall is thickened or not before surgery for granulation hyperplasia,lacrimal sac stent implantation under nasal endoscopy combined with lacrimal duct placement can not only increase the total effective rate,which exceeds

关 键 词：慢性泪囊炎 泪囊支架植入 泪道置管 治愈率 

分 类 号：R779.6[医药卫生—眼科]