杨海澎　管家忠　陈志彬　李沁654399云南省建水县人民医院眼科



改良泪囊鼻腔吻合术联合泪道引流管置入治疗慢性泪囊炎的效果观察

杨海澎管家忠陈志彬李沁
654399云南省建水县人民医院眼科

摘要目的：探讨泪囊鼻腔吻合术联合泪道引流管置入治疗慢性泪囊炎的临床效果。方法：收治慢性泪囊炎患者22例，给予泪囊鼻腔吻合术联合泪道引流管置入治疗，观察临床效果。结果：术后6～12个月拔管后行泪道冲洗，全部通畅，随访12个月后，有效率达95%。结论：泪囊鼻腔吻合术联合泪道引流管置入治疗慢性泪囊炎手术操作简便，成功率高。

关键词泪囊鼻腔吻合术；慢性泪囊炎；泪道引流管置入

Curative effect observation of modified dacryocystorhinostomy combined with lacrimal duct drainage tube placement in the treatment of chronic dacryocystitis

Yang Haipeng,Guan Jiazhong,Chen Zhibin,Li Qin Department of Ophthalmology,Jianshui County People's Hospital of Yunnan Province 654399

Abstract Objective:To explore the clinical curative effect of modified dacryocystorhinostomy combined with lacrimal duct drainage tube placement in the treatment of chronic dacryocystitis.Methods:22 patients with chronic dacryocystitis were selected. They were given modified dacryocystorhinostomy combined with lacrimal duct drainage tube placement treatment.The clinical curative effect was observed.Results:After postoperative 6 to 12 months,the patients were given lacrimal passage irrigation after extubation,the lacrimal passages were all unobstructed.The effective rate was 95% after 12 months of follow-up.Conclusion:The dacryocystorhinostomy combined with lacrimal duct drainage tube placement in the treatment of chronic dacryocystitis has simple operation technique,and high success rate.

Key words Dacryocystorhinostomy;Chronic dacryocystitis;Lacrimal duct drainage tube placement

慢性泪囊炎是临床上的常见病，主要症状有流脓、流泪，以手术治疗方式为主，泪囊鼻腔吻合术(DCR)是治疗的最有效的手段，但传统DCR术后有一定的反复，手术成功率90%左右[1]。2010年4月-2014年4月收治慢性泪囊炎患者22例，给予改良DCR联合泪道引流管置入治疗，效果显著，现报告如下。

资料与方法

2010年4月-2014年4月收治慢性泪囊炎患者22例，给予改良DCR联合泪道引流管置入治疗，其中女19例，男3例，其中2例女性患者合并下泪小管阻塞，年龄23～74岁。病程6个月～10余年。材料：泪道引流管(引流管两端带橄榄头探针)。所有患者符合慢性泪囊炎诊断标准，泪道冲洗提示鼻泪管阻塞及泪小管阻塞，且排除鼻息肉、鼻甲肥大、严重鼻中隔偏曲等鼻腔疾病。

方法：术前准备、麻醉同常规DCR。沿泪前嵴作一弧形切口，长1.2 cm，将皮下组织分离，达到泪前嵴，沿泪前嵴偏内侧垂直切开骨膜，用骨膜剥离器将泪囊连同骨膜向下剥离至泪囊窝，将泪囊窝充分暴露。……