鼻内窥镜下鼻腔泪囊吻合术治疗先天性泪点发育不全伴泪囊黏液囊肿的效果观察  

Efficacy of endoscopic dacryocystorhinostomy for congenital lacrimal dot hypoplasia with lacrimal sac mucocele

作　　者：郑颖洁 张一 范金鲁 郑群[3] Zheng Yingjie;Zhang Yi;Fan Jinlu;Zheng Qun(Department of Ophthalmology,Shaying Hospital,Ma'anshan City,Anhui 243121,China;Jinzhou Aier Ophthalmic Hospital,Liaoning 121000,China;Nanjing Aier Ophthalmic Hospital,Nanjing 210001,China)

机构地区：[1]安徽省马鞍山市砂迎医院眼科,243121 [2]辽宁省锦州爱尔眼科医院,121000 [3]南京爱尔眼科医院,210001

出　　处：《眼科》2022年第4期286-291,共6页Ophthalmology in China

摘　　要：目的观察鼻内窥镜下鼻腔泪囊吻合手术治疗先天性泪点发育不全伴泪囊黏液囊肿的效果。设计回顾性病例系列。研究对象2004-2021年南京爱尔眼科医院先天性泪点发育不全伴泪囊黏液囊肿行鼻内窥镜下鼻腔泪囊吻合手术者13例(17眼),平均年龄(8.1±14.2)岁(生后6天~43岁)。方法回顾患者的病历资料。患者均行鼻内窥镜下鼻腔泪囊吻合术。平均随访(20.0±15.7)个月。手术成功定义为术后囊肿未再次形成、鼻腔泪囊吻合口直径≥1.0 mm。主要指标手术成功率、手术并发症。结果末次随访时手术成功率94.1%(16/17眼),失败率(1/17眼)5.8%。1例术中鼻中隔黏膜损伤,术后1个月泪囊吻合区黏膜与鼻中隔粘连,分离粘连后吻合孔形成;1例术后1.5个月囊肿复发,造孔区上方存在游离死骨。结论鼻内窥镜下鼻腔泪囊吻合术是治疗先天性泪点发育不全伴泪囊黏液囊肿的一种良好方法。但泪道旁路引流插管手术尚需Ⅱ期进行。Objective To observe the efficacy of endoscopic dacryocystorhinostomy for congenital lacrimal point hypoplasia with lacrimal sac mucocele.Design Retrospective case series.Participants 13 cases(17 eyes)with congenital lacrimal dot dysplasia and lacrimal sac mucocele underwent endoscopic dacryocystorhinostomy in Nanjing Aier Ophthalmic Hospital from 2004 to 2021,with an average age of(8.1±14.2)years(range:6 days to 43 years).Method Medical records of patients were reviewed.All patients underwent endoscopic dacryocystorhinostomy.The mean follow-up was(20.0±15.7)months.The successful operation was defined as that the cyst disappeared and the diameter of nasolacrimal sac anastomosis was 1.0 mm or larger.Main Outcomes Measure Surgical success rate and complications.Results At the last follow-up,the success rate was 94.1%(16/17 eyes)and the failure rate was 5.8%(1/17 eye).One case had nasal septal mucosa injury during operation,and 1 month after operation there was adhesion between the mucosa of lacrimal sac anastomosis area and nasal septum.The adhesion was separated with gelatin sponge,and the anastomotic hole was formed 2 months later.One case of lacrimal cyst recurred 1.5 months after operation,and free dead bone was found on the foramen area.Conclusions Endoscopic dacryocystorhinostomy for the treatment of congenital lacrimal insufficiency with lacrimal sac mucocele is a good method.However,the lacrimal passage bypass drainage and intubation operation still needs to be carried out in stage Ⅱ.

关 键 词：先天性泪点发育不全 泪囊黏液囊肿 鼻内窥镜下鼻腔泪囊吻合术 

分 类 号：R779.6[医药卫生—眼科]