鼻内镜下泪囊鼻腔造孔术的护理

目的探讨鼻内镜下泪囊鼻腔造孔术治疗外伤性鼻泪管阻塞的护理及治疗效果.方法10例外伤性鼻泪管阻塞患者接受了鼻内镜下泪囊鼻腔造孔术.结果10例接受鼻内镜下泪囊鼻腔造孔术的患者术后症状缓解,鼻腔造瘘口通畅.结论鼻内镜下泪囊鼻腔造孔术是治疗外伤性鼻泪管阻塞的有效方法,而且具有损伤小,方法简便,并发症少等优点.     

鼻内镜下泪囊鼻腔造孔术的护理

目的：探讨鼻内镜下泪囊鼻腔造孔术治疗外伤性鼻泪管阻塞的护理及治疗效果。方法：10例外伤性鼻泪管阻塞患者接受了鼻内镜下泪囊鼻腔造孔术。结果：10例接受鼻内镜下泪囊鼻腔造孔术的患者术后症状缓解，鼻腔造瘘口通畅。结论：鼻内镜下泪囊鼻腔造孔术是治疗外伤性鼻泪管阻塞的有效方法，而且具有损伤小，方法简便，并发症少等优点。     

鼻内镜T泪囊鼻腔造口术治疗慢性泪囊炎57例分析

目的：探讨鼻内镜下泪囊鼻腔造口术的方法与临床效果。方法：57例慢性泪囊炎患者经鼻内镜下泪囊鼻腔造口术治疗。结果：54例术后症状缓解,鼻腔造瘘口通畅,3例阻塞,其中2例经再次手术治愈。结论：鼻内镜下泪囊鼻腔造口术是治疗鼻泪管阻塞的有效方法,值得推广。     

改良鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎的护理

目的探讨改良鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎的护理方法及其效果。方法对52例慢性泪囊炎患者在鼻内镜下完成泪囊鼻腔造孔术治疗及精心护理。结果52例（53眼）中，51例（52眼）治愈，症状完全消失，泪道冲洗畅通，内镜检查造孔通畅。1例（1眼）症状改善不明显。总有效率97．8％。所有患者未出现严重并发症。结论改良鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎，手术损伤小，经过精心护理，手术成功率高，并发症少。     

鼻内镜下鼻腔泪囊开窗或吻合扩张治疗鼻泪管阻塞

目的 探讨鼻内镜下经鼻腔手术治疗鼻泪管阻塞的适应证、手术方法和技巧.方法 回顾分析2001～2005年开展的鼻泪管阻塞患者经鼻内镜下行泪骨、上颌骨额突造口,鼻腔泪囊开窗法或吻合扩张法手术治疗45例(47眼)患者的临床资料.结果 术后随访6～ 12个月,治愈41眼,占87.23％;好转1眼,占2.13％;无效5眼,占10.64％.结论 该手术适应广泛:慢性或复发性泪囊炎、泪囊黏液囊肿、外伤性鼻泪管阻塞等,只要有可探及并可实施造口操作的泪囊结构均适合此手术.以鼻腔泪囊开窗法为佳.对于小泪囊、泪囊粘连或分隔形成等,可行引入扩张管或扩张纱条即吻合扩张法手术.该手术方法明显好于于鼻外内眦切开法.     

鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎

目的:探讨鼻内镜下鼻腔泪囊造孔术治疗慢性泪囊炎的手术方式及临床疗效。方法:对82例(85眼)慢性泪囊炎、鼻泪管阻塞患者采用经鼻内镜行泪囊鼻腔造孔术,术中予泪囊硅胶管置管,留置于中鼻道3～6个月。结果:术后随访6个月～2年,其中,治愈80眼(94.1%),好转4眼(4.7%),无效1眼(1.2%)。结论:该术式具有创伤小,面部不遗留瘢痕,操作简便及并发症少等特点。术中植入硅胶管及重视术后随访是提高手术成功率的重要措施。     

60例慢性泪囊炎鼻内镜手术疗效观察

60例慢性泪囊炎患者随机分为内镜组和对照组各30例。内镜组给予鼻内镜下泪囊鼻腔造孔术。对照组给予鼻外泪囊鼻腔吻合术。结果内镜组总有效率93.33%,对照组总有效率90.00%,两组比较差异无统计学意义(P>0.05)。内镜组患者术后满意度评分为83.48±11.36分,对照组患者术后满意度评分为76.72±10.65分,两组比较差异具有统计学意义(P<0.05)。鼻外泪囊鼻腔吻合术和鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎的疗效相当,但鼻内镜下泪囊鼻腔造孔术具有面部不留瘢痕,微创,美容,恢复快,术后患者满意度高。     

鼻内镜下鼻腔泪囊造孔术14例临床分析

慢性泪囊炎为眼科常见病，治疗原则是解除阻塞、消除感染、重新建立鼻内引流通道。过去主要采用经鼻外内眦部行泪囊鼻腔吻合，近年来，经鼻腔的鼻内镜下鼻腔泪囊造口术已较广泛应用。本科2004年1月至2007年1月，应用鼻内镜下鼻腔泪囊造孔术治疗慢性泪囊炎14例，效果满意。     

经鼻内镜下行泪囊鼻腔造孔术

目的　探讨经鼻内镜下行泪囊鼻腔造孔术治疗慢性泪囊炎的临床价值。方法　对 19例慢性泪囊患者进行经鼻内镜下行泪囊鼻腔造孔术 ,16例术后随访 6个月以上 ,3例术后 2个月失访。结果　本组 19例 (2 1眼 )慢性泪囊患者 ,19眼治愈 ,2眼好转 ,未见严重并发症。结论　经鼻内镜下行泪囊鼻腔造孔术具有术野清晰 ,操作简单 ,无面部切口疤痕 ,损伤小等优点 ,值得临床推广应用。     

经鼻内镜鼻腔泪囊造孔术的围手术期护理

目的探讨经鼻内镜鼻腔泪囊造孔术治疗慢性泪囊炎的护理方法.方法对45例慢性泪囊炎患者应用鼻内镜行鼻腔泪囊造孔术,术前进行有效的心理护理,鼻腔冲洗指导,术后加强术腔管理,预防并发症.结果本组45例患者术前心理状态稳定,手术效果满意,术后未发生严重并发症.结论经鼻内镜鼻腔泪囊造孔术是治疗慢性泪囊炎的有效方法,加强术前术后心理护理,及术后术侧鼻腔的管理,进行有针对性的健康指导,加强术后随访,是手术成功的重要保证.     

Endoscopic transnasal dacryocystorhinostomy -long-term results

Summary

Endoscopic dacryocystorhinostomy (DCR) was successfully performed in 40 patients, with four patients having bilateral surgery. Follow-up data were obtained on 43/44 eyes using clinical notes and a patient questionnaire. Range of follow up was 1–46 months, with an average of 18 months (in nine patients follow up was at least 3 years). Epiphora was successfully relieved in 86% of patients and there was no evidence of a recurrence of nasolacrimal obstruction in the long term. Endoscopic DCR is a relatively quick and simple procedure with low morbidity, and as such is suitable for day case surgery. Satisfactory long-term results make endoscopic DCR an alternative to external DCR as primary surgical treatment for nasolacrimal duct obstruction. In cases of failed external DCR, or when epiphora is iatrogenic following surgery to the lateral nasal wall, a transnasal endoscopic approach is probably the treatment of choice.     

鼻内窥镜下泪囊鼻腔电钻造孔术的应用

目的探讨43例(48眼)鼻内窥镜下利用电钻行鼻腔泪囊造孔治疗慢性泪囊炎的疗效。方法电钻鼻腔泪囊造孔及鼻腔病变同期手术。结果48眼中治愈45眼，治愈率93．8％，好转2眼，好转率4．1％，无效1眼，占2．1％。结论该手术具有损伤小、操作简便、快捷、术后反应轻、并发症少等优点，应得到临床广泛推广应用。     

经鼻内窥镜泪囊窝造口大隐静脉或唇黏膜移植再造泪道:18例分组比较

背景:国内外对严重泪道阻塞的治疗,还没有理想的方法.如何改进手术方式,选择合适的移植材料,提高治疗效果,容易让患者接受是泪道阻塞诊治研究工作者的课题.目的:评估经鼻内窥镜泪囊窝造口自体大隐静脉或居黏膜移植泪道再造的有效性和安全性.设计、时间及地点:对比观察,于2005-04/2007-06在武装警察部队总医院完成.对象:选择武装警察部队总医院收治的上、下泪小管严重阻塞合并泪囊缺失或萎缩患者18例伯眼.方法:根据移植材料分为2组,大隐静脉组9例,口唇黏膜组9例.大隐静脉组采用自体大隐静脉移植,口唇黏膜组采用自体口唇黏膜移植.对2组患者移植后泪道通畅情况、泪溢症状改善的程度和并发症等做统计分析.主要观察指标:移植后带管期间泪溢症状改善情况,拔管后泪道探查冲洗情况,拔管后第12周泪道放射性核素~(99)Tc~m(TcO_4~-)显影检查核素入鼻时间,判定治疗效果.结果:两组患者移植后带管3个月期间,泪溢症状即可得到不同程度的改善.拔管后第12周,泪道放射性核素88Tcm显影检查,核素入鼻时间分别为(8.58±4.3)min和(9.16±5.8)min,两组差异无显著性意义(P＞0.05).大隐静脉组和口唇黏膜组的治愈病例分别是6例和5例,好转病例均为2例,无效病例数分别为1例和2例.结论:经鼻内窥镜泪囊窝造口自体大隐静脉或唇黏膜移植泪道再造治疗严重泪道阻塞安全、有效,自体大隐静脉和唇黏膜作为移植材料各有优缺点.     

鼻内镜下鼻腔泪囊造口术

目的 观察鼻内镜下鼻腔泪囊造口术治疗慢性泪囊炎的疗效和特点。方法 对34例慢性泪囊炎患者行鼻内镜下鼻腔泪囊造口术。术中采用枪状镊鼻内定位泪囊，用电钻磨除泪囊内侧壁骨质，切开泪囊，银夹固定翻开的泪囊黏膜，术后随访半年以上。结果 全部病例中治愈31例（91％），好转4例（9％）。结论 经鼻内镜鼻腔泪囊造口术较传统鼻外泪囊鼻腔造口术操作更加简便，可控。     

Congenital tear duct obstruction

Congenital nasolacrimal duct obstruction is a classic condition that has been well investigated and is readily identified. The suggested sequence of treatment includes massage, irrigation, probing, insertion of a silicone stent and, finally, dacryocystorhinostomy. Because of the relatively frequent occurrence of duct obstruction in normal infants, family physicians need to be familiar with its diagnosis and treatment. If problems still exist after an adequate trial of conservative treatment, referral before six months of age is suggested.     

逆行性人工鼻泪管植入修复泪道阻塞性疾病：18个月随访（英文）

背景：人工鼻泪管植入治疗泪道阻塞性疾病不会改变泪道的解剖结构,是一种简单有效的治疗方法。目的：评价人工鼻泪管植入治疗泪道阻塞性疾病的有效性及安全性。方法：选择2008/2009逆行性人工鼻泪管植入治疗泪道阻塞患者87例,共94眼,年龄26～71岁,平均56岁。其中鼻泪管阻塞患者31例,慢性泪囊炎患者56例。随访时间为18个月。结果与结论：人工鼻泪管植入后第2天92眼溢泪症状完全缓解,成功率为98%（92/94）。随访中,85眼人工鼻泪管保持通畅,8眼发生阻塞,1眼发生人工鼻泪管移位,植入有效率为90%（85/94）。植入后有7例患者出现疼痛,2例出现眼睑水肿,所有患者均有少量鼻出血,经对症处理后均缓解。结果可见人工鼻泪管植入是治疗泪道阻塞性疾病简单有效安全的方法。     

Endoscopic guided single self-linking silicone stent in pediatric external dacryocystorhinostomy

Abstract

Aims: To study the efficacy of a new technique of single self-linking silicone stent exclusively in pediatric external dacryocystorhinostomy (DCR) and to report the new use and advantages of endoscopic guidance for the same. Material and methods: Prospective interventional case series, including 11 eyes of ten patients with nasolacrimal duct obstruction. Data collected included demographic data, clinical presentation, laterality, status of lids and puncta, syringing findings, probing interpretations, types and duration of intubation. Consecutive pediatric patients with post-saccal obstruction who underwent an external dacryocystorhinostomy were included. Exclusion criteria included patients who had undergone a DCR in the past by any route via external, endonasal or transcanalicular. Primary outcome measures were stent retention and ease of stent removal. Secondary outcome measures were anatomic patency of the passage and resolution of symptoms. Results: There were three male and seven female patients. Mean age was 9.4 years (range 6–15). A total of 11 procedures were carried out. Following placement of self-linked stents, the removal was done at a mean duration of 13.2 weeks (range:12–16 weeks). None of the patients had a stent prolapse during this period. All stents were removed in the outpatient without the use of general anesthesia with minimal endoscopic guidance. A minimum follow-up of three months following removal was considered for final analysis. Follow-up ranged from three months to six months after tube removal. The anatomical and functional success rate was 91%. There was one anatomical failure three months following tube removal and the remaining patients were free of symptoms at the last follow-up. Conclusions: Self-linking stents are a useful modality in pediatric patients not only to prevent stent prolapse but also to allow easy removal with minimum discomfort. Endoscopic guidance is a useful addition to this technique.     

泪囊鼻腔吻合术术后复发经鼻内窥镜下手术治疗

目的 观察慢性泪囊炎行泪囊鼻腔吻合术术后复发经鼻内窥镜下手术治疗的疗效,探讨泪囊鼻腔吻合术术后复发的有效治疗方法.方法 对13例(14眼)慢性泪囊炎行泪囊鼻腔吻合术术后复发的患者应用经鼻内窥镜下再次手术治疗,术后随访6个月～ 2年,复查时行泪道冲洗及鼻内镜检查.结果 9例10眼治愈,占71.4%;2例2眼有效,占14.3%;2例2眼无效.总有效率85.7%.结论 经鼻内窥镜下手术治疗泪囊鼻腔吻合术术后复发,手术简便,成功率高,不再次造成面部瘢痕,是一种有效的手术方法.     

Computed tomography imaging features for amyloid dacryolith in the nasolacrimal excretory system: A case report

BACKGROUNDNasolacrimal duct obstruction leading to epiphora is a common ophthalmologic complaint, and it may derive from amyloidosis in rare cases. There are a few reports about localized amyloidosis, and amyloidosis with involvement and obstruction of the nasolacrimal duct is exceedingly rare. CASE SUMMARYA 54-year-old male presented with a 2-year history of a lump overlying the left lacrimal sac that had grown rapidly for nearly half a year. Physical examination touched a firm lump in the left lacrimal sac. Nasal endoscopy discovered lesions in appearance of sediments with easy bleeding at the entry of the nasolacrimal duct of the left inferior nasal meatus. Computerized tomography scan revealed speckle high density in the left lacrimal sac and the dilated nasolacrimal duct. During an endoscopic exploration and excision, a large number of dacryoliths were exposed. Pathology indicated amorphous pink material and multinucleated giant cell reaction in the fibrous tissue.CONCLUSIONThis case showed amyloidosis in localized form mimicking dacryolith with nasolacrimal duct obstruction. In clinical practice, we should be aware of the possibility of localized amyloidosis in the nasolacrimal excretory system.