中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2014年
2期
228-230
,共3页
慢性泪囊炎%泪囊鼻腔吻合术%高速磨钻
慢性淚囊炎%淚囊鼻腔吻閤術%高速磨鑽
만성루낭염%루낭비강문합술%고속마찬
Chronic dacryocystitis%Dacryocystorhinostomy%High-speed drill
目的 探讨泪囊鼻腔吻合术的改进方法.方法 回顾总结2009年10月至2012年12月在遵义医学院附属医院眼科收治慢性泪囊炎患者258例(286只眼),采用泪囊鼻腔吻合术治疗,术中用高速磨钻制作骨窗,泪道环形置入硅胶管,8-0可吸收线吻合前后瓣,术后3～6个月拔出硅胶管.结果 术后3～6个月,16只眼(5.6％)内眦部轻度异物感,均能耐受;8只眼(2.8％)泪小点及结膜局限性充血,拔管后均好转;5只眼硅胶管上端部分滑出泪小点,均顺利放置回泪道.3例患者挖鼻孔扯断硅胶管滑出,冲洗通畅未再置管;无泪小点豁裂开等严重并发症.拔管后随访3个月至3年,治愈267只眼,治愈率93.4％ (267/286);有效19只眼,有效率6.6％ (19/286);未见无效及复发患者.结论 鼻腔泪囊吻合术采用高速磨钻制作骨窗,泪道环形置入硅胶管,手术效果显著,扩大了鼻腔泪囊吻合术的适应证.
目的 探討淚囊鼻腔吻閤術的改進方法.方法 迴顧總結2009年10月至2012年12月在遵義醫學院附屬醫院眼科收治慢性淚囊炎患者258例(286隻眼),採用淚囊鼻腔吻閤術治療,術中用高速磨鑽製作骨窗,淚道環形置入硅膠管,8-0可吸收線吻閤前後瓣,術後3～6箇月拔齣硅膠管.結果 術後3～6箇月,16隻眼(5.6％)內眥部輕度異物感,均能耐受;8隻眼(2.8％)淚小點及結膜跼限性充血,拔管後均好轉;5隻眼硅膠管上耑部分滑齣淚小點,均順利放置迴淚道.3例患者挖鼻孔扯斷硅膠管滑齣,遲洗通暢未再置管;無淚小點豁裂開等嚴重併髮癥.拔管後隨訪3箇月至3年,治愈267隻眼,治愈率93.4％ (267/286);有效19隻眼,有效率6.6％ (19/286);未見無效及複髮患者.結論 鼻腔淚囊吻閤術採用高速磨鑽製作骨窗,淚道環形置入硅膠管,手術效果顯著,擴大瞭鼻腔淚囊吻閤術的適應證.
목적 탐토루낭비강문합술적개진방법.방법 회고총결2009년10월지2012년12월재준의의학원부속의원안과수치만성루낭염환자258례(286지안),채용루낭비강문합술치료,술중용고속마찬제작골창,루도배형치입규효관,8-0가흡수선문합전후판,술후3～6개월발출규효관.결과 술후3～6개월,16지안(5.6％)내자부경도이물감,균능내수;8지안(2.8％)루소점급결막국한성충혈,발관후균호전;5지안규효관상단부분활출루소점,균순리방치회루도.3례환자알비공차단규효관활출,충세통창미재치관;무루소점활렬개등엄중병발증.발관후수방3개월지3년,치유267지안,치유솔93.4％ (267/286);유효19지안,유효솔6.6％ (19/286);미견무효급복발환자.결론 비강루낭문합술채용고속마찬제작골창,루도배형치입규효관,수술효과현저,확대료비강루낭문합술적괄응증.
Objective To investigate an improved method of dacryocystorhinostomy.Methods Retrospective reviewed the cases of chronic dacryocystitis at our hospital from October 2009 to December 2013 which were treated by dacryocystorhinostomy.During the dacryocystorhinostomy,the bone hole was made by high-speed drill,placed the ring silicone tube to lacrimal,and anastomosed the front and back flaps mucosal flap with 8-0 absorbable suture.The tube was pulled out 3-6 months after the surgery.All patients were followed up for 3 months to 3 years after the operation.Results Of 16 eyes (5.6％) with mild foreign body sensation and 8 eyes (5.6％) with local congestion within 3-6 months were cured after tube pulled out.The slided tube was re-placed back to lacrimal in 5 eyes (1.7％).The tom tube was not placed back to lacrimal in 3 eyes (1.0％).There were no other complications such as lacrimal punctum dehiscence.After follow up time from 3 months to 3 years on tube off,267 eyes (93.3％) were cured,19 (6.7％) improved.There were no invalid and relapsed patients.Conclusions Improved dacryocystorhinostomy with the bone hole made by high-speed drill and placed the ring silicone tube to lacrimal,enhance the effect of surgery and expand the indications of dacryocystorhinostomy.
