CAJ | 학술논문

目的探讨在泪道内镜下行环钻术治疗复发性上泪道阻塞的方法及其临床疗效.方法回顾性系列病例研究.收集2007年2月至2008年2月南京医科大学第二附属医院眼科67例(73只眼)复发性上泪道阻塞患者的病历资料.患者局部麻醉后在泪道内镜下通过检查确定阻塞性质和部位,然后采用微型环钻清除泪道阻塞物并置人硅胶管治疗,拔管后随访6个月,观察疗效.结果术后3～5个月,73只眼均顺利拔管.其中51只眼(69.86%)治愈,即无流泪,泪道冲洗通畅;19只眼(26.03%)好转,即轻微流泪,泪道冲洗通,但不畅;3只眼(4.11%)无效,即仍流泪,泪道冲洗不通.有效率为95.89%(70/73).且上下泪小管阻塞合并鼻泪管阻塞的有效率低于单纯下泪小管阻塞或泪总管阻塞.结论泪道内镜下环钻术是一种安全、有效的治疗复发性上泪道阻塞的手术,可明显提高治疗复发性上泪道阻塞的成功率.
목적 탐토재루도내경하행배찬술치료복발성상루도조새적방법급기림상료효.방법 회고성계렬병례연구.수집2007년2월지2008년2월남경의과대학제이부속의원안과67례(73지안)복발성상루도조새환자적병력자료.환자국부마취후재루도내경하통과검사학정조새성질화부위,연후채용미형배찬청제루도조새물병치인규효관치료,발관후수방6개월,관찰료효.결과 술후3～5개월,73지안균순리발관.기중51지안(69.86%)치유,즉무류루,루도충세통창;19지안(26.03%)호전,즉경미류루,루도충세통,단불창;3지안(4.11%)무효,즉잉류루,루도충세불통.유효솔위95.89%(70/73).차상하루소관조새합병비루관조새적유효솔저우단순하루소관조새혹루총관조새.결론 루도내경하배찬술시일충안전、유효적치료복발성상루도조새적수술,가명현제고치료복발성상루도조새적성공솔.
Objective To evaluate the efficacy of trephination under lacrimal endoscopy in the treatment of relapse canalicular obstruction.Methods In this retrospective cases series,67 patients (73 eyes) with relapse canalicular obstruction were examined and treated in the Second Affiliated Hospital of Nanjing Medical University between Feb.2007 and Feb.2008.These patients were examined by endoscopy of the lacrimal drainage system under local anesthesia,the obstructions were treated with miniature annulal drill and silicone stent intubation.All patients were followed up for 6 months postoperatively.Results Silicone tubes were successfully removed after 3 to 5 months postoperatively in all eyes.After followed up for 6 months, the complete succful rate,as defined on a total relief of epiphoria and patent on nasolacrimal irrigation,was 69.86%(51/73).Nineteen eyes (26.03%)showed improvement,which showed slight epiphoria and were unobstructed during irrigation of lacrimal passage.Three eyes (4.11%)were failure,which still had epiphoria and showed reflex during nasolacrimal irrigation.The effective rate of treatment was 95.89%(70/73).The effective rate for the treatment of upper and lower canalicular obstruction combined with nasolacfimal duct obstruction was lower than that of simple lower canalicular obstruction or conmmon canalicular obstruction.Conclusions Trephination under lacrimal endoscopy is a nontraumatic and effective procedure for the treatment of relapse canalicular obstruction.It significantly improves the effective rate of treatment for canalicular obstruction.