慢性泪囊炎合并泪总管阻塞的手术治疗

目的:探讨慢性泪囊炎合并泪总管阻塞的手术方法及临床效果。方法:慢性泪囊炎合并泪总管阻塞患者46例48眼,全部先有流泪、脓性分泌物病史,直至泪囊区出现硬结,红肿,甚至皮肤溃破,经泪道冲洗检查确诊,行改良泪囊鼻腔吻合联合硅胶管植入术,术后随访3a,定期冲洗泪道,观察手术效果。结果:无流泪、脓性分泌物46眼(96%),泪囊区红肿消失,冲洗泪道通畅。2眼仍有流泪,无脓性分泌物,泪囊区红肿消失,泪道冲洗通畅,有效率100%。结论:改良泪囊鼻腔吻合联合硅胶管植入术一次性解决了鼻泪管泪总管同时阻塞的问题,避免患者再次手术的痛苦,减轻经济负担,是治疗慢性泪囊炎合并泪总管阻塞的有效方法。

Operative treatment for chronic dacryocystitis with obstruction to lacrimal canaliculi

AIM: To investigate the surgical methods and clinical effects for chronicdacryocystitis with obstruction to lacrimal canaliculi.

METHODS: Totally 46 cases(48 eyes)who suffered from chronicdacryocystitis with obstruction to lacrimal canaliculi underwent an operation to implant improved dacrocystorhinostomy combined with the silicone tube after diagnosis. All of them had a history of the tears purulent secretions. And indurations appeared on the lacrimal sac area which was swelling and even the skin ulcerated. After operation, the patients flushed lacrimal duct regularly and they were followed up 3 years in order to observe the surgical results.

RESULTS:Totally 46 eyes(96%)had no tears, purulent discharge, and the lacrimal sac district redness disappeared, irrigation of lacrimal passage was passable. 2 cases(4%)still had tears, with no purulent discharge, the lacrimal sac district redness disappearing. The lacrimal passages were unobstructed and the effective rate was 100%.

CONCLUSION: Improved dacrocystorhinostomy combined implantation with silicone tube, which helps to solve the problem of obstruction of nasolacrimal duct and lacrimal canaliculi only by one time, to alleviate patients'suffering of the reoperation and to ease their financial burden, is an effective method for chronic dacryocystitis with obstruction of lacrimal canaliculi.