CAJ | 학술논문

目的对泪道阻塞的手术治疗方式进行分析.方法总结2075例(2332眼)泪道阻塞,根据阻塞部位及程度选择不同手术方式,并对术后效果进行分析.泪道狭窄或阻塞伴炎症表现者行泪囊鼻腔吻合手术或人工泪管植入手术;泪道阻塞无炎症表现者根据患者主诉的溢泪严重程度决定是否手术;泪小管末端阻塞或泪总管阻塞行泪小管或泪总管鼻腔吻合手术;泪小管大部阻塞或缺如行泪道旁路手术.结果泪道不同阻塞部位和程度通过不同手术方式获得的术后效果不同,具有统计学意义.不同阻塞部位的手术成功率依次递减的次序为:泪囊和鼻泪管、泪总管、泪小管.辅助使用人工泪管后,泪囊鼻腔吻合术成功率由94.12％提高到99.75％;泪总管阻塞的泪小管鼻腔吻合术成功率由89.50％提高到99.69％;泪小管部分阻塞的泪小管鼻腔吻合术成功率由77.70％提高到99.55％.结论泪道冲洗是诊断泪道疾病的重要手段;使用人工泪管有利于提高泪道重建手术的成功率,但应根据泪道阻塞情况选择不同人工泪管;泪道手术可以与眼眶整复手术或眼睑内眦畸形矫正手术同期进行.
목적 대루도조새적수술치료방식진행분석.방법 총결2075례(2332안)루도조새,근거조새부위급정도선택불동수술방식,병대술후효과진행분석.루도협착혹조새반염증표현자행루낭비강문합수술혹인공루관식입수술;루도조새무염증표현자근거환자주소적일루엄중정도결정시부수술;루소관말단조새혹루총관조새행루소관혹루총관비강문합수술;루소관대부조새혹결여행루도방로수술.결과 루도불동조새부위화정도통과불동수술방식획득적술후효과불동,구유통계학의의.불동조새부위적수술성공솔의차체감적차서위:루낭화비루관、루총관、루소관.보조사용인공루관후,루낭비강문합술성공솔유94.12％제고도99.75％;루총관조새적루소관비강문합술성공솔유89.50％제고도99.69％;루소관부분조새적루소관비강문합술성공솔유77.70％제고도99.55％.결론 루도충세시진단루도질병적중요수단;사용인공루관유리우제고루도중건수술적성공솔,단응근거루도조새정황선택불동인공루관;루도수술가이여안광정복수술혹안검내자기형교정수술동기진행.
Objective To analyze the surgical management of lacrimal duct obstruction.Methods 2075 cases (2332 eyes) of lacrimal duct obstruction were analyzed.Surgical procedures depended on the position and degree of obstruction.Surgical options were dacryocystorhinostomy (for dacryocystitis),canaliculorhinostomy (for cases with obstruction at the end of canaliculus or common canaliculus) and bypass surgery (when most canaliculi were obstructed or canaliculi could not be found).Results The success rate decreased from lacrimal sac,nasolacrimal duct to common canaliculus and canaliculi.With artifictial duct,the success rates of dacryocystorhinostomy and canaliculorhinostomy raised from 94.12％ to 99.75％ and from 89.50％ to 99.69％.The success rate of canaliculorhinostomy for partial obstruction in canaliculi raised from 77.70％ to 99.55％.Conclusion Lacrimal irrigation is the important diagnostic skill.Artificial duct application can improve the surgical success rate.