球头硅胶管植入术治疗慢性泪囊炎.docxVIP

? ? 球头硅胶管植入术治疗慢性泪囊炎 ? ? 李乐义　徐长华　王庆娟 【Summary】 目的 观察球头硅胶管植入术治疗慢性泪囊炎的临床疗效。方法 慢性泪囊炎患者131例(138眼)，在泪道和鼻腔粘膜表面麻醉下行球头硅胶管逆行植入术。术后1周冲洗泪道1次/d，之后每个月冲洗泪道1次。结果 所有患者术中均成功植入球头硅胶管，手术时间平均8．5 min。术后溢泪症状立即改善，泪道冲洗均通畅。观察8~37个月，平均15．5个月。不流泪，冲洗泪道通畅121眼(87．68%)；流泪，冲洗泪道不通17眼(12．32%)。结论 球头硅胶管植入术治疗慢性泪囊炎，操作简便，效果良好，值得临床推广。 【Key】慢性泪囊炎；球头硅胶管植入 お Spherical headed silicon tube implantation for the treatment ofchronic dacrycystitis LI Le-yi，XU Chang-hu，WANG Qing-juan.Lianyungang Ophthalmology Hospital， Lianyungang,Jiangsu 222001，China 【Abstract】 Objective To observe the clinical outcome ofspherical headed silicon tube implantation in patient with chronic dacrycystitis.Methods 131 patients(138 eyes)with chronic dacrycystitis were implanted with spherical headed silicon tube via nasol cavity under the topical anesthesia.Lacrimal duct was douched daily for the first week of post-operation and once month thereafter.Results Spherical headed silicon tube placement was technically successful in all eyes.The mean operative time was 8．5 mintues.The symptoms of epiphora were immediately resoluted and irrigation showed patency of lacrimal system in all patients.Patients were followed up from 8~37 months(mean 15．5 months).The symptoms of lachrymation were improved.The lacrimal ducts of 121 eyes(87．68%)were normal.The lacrimal ducts of others(12．32%)were still blocked.Conclusion Spherical headed silicon tube implantation was a simple， effective and safe technique in treatment ofchronic dacrycystitis，and worthy of widely use in clinic. 【Key words】Chronic dacrycystitis;Spherical headed silicon tube implantation 慢性泪囊炎是眼科常见病，传统的治疗方法是泪囊鼻腔吻合术，因为手术复杂、创伤大,年老体弱患者难以耐受；又因面部留有切口瘢痕使年轻患者不易接受。近年来开展的鼻泪道疏通置管术因创伤小、面部无瘢痕扩大了手术适应证。连云港市眼科医院自2004年7月至2008年采用球头硅胶管(广州博视医疗保健研究所)植入术治疗慢性泪囊炎取得良好效果，现报告如下。 1 资料与方法 1．1 一般资料 2004年7月至2008年在本院顺利行球头硅胶管植入术的慢性泪囊炎患者131例(138眼)，所有患者术前泪道冲洗确诊鼻泪管阻塞引起慢性泪囊炎，鼻腔检查排除下鼻甲肥大、鼻腔息肉等疾病。其中男9例(9眼)，女122例(129眼)。年龄32~77岁，平均54．2岁。≤45岁38例(40眼)，≥65岁14例(15眼)。 1．2 器械 7号长8 cm空心泪道探针，尼龙线制成的直径3 mm扩张绳，球头硅胶管(空心圆管，长3．5 cm、球头外径4．2