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中华眼科医学杂志(电子版) ›› 2018, Vol. 08 ›› Issue (04) : 170 -174. doi: 10.3877/cma.j.issn.2095-2007.2018.04.005

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论著

鼻窦内窥镜下泪囊鼻腔造孔术治疗慢性泪囊炎的临床观察
秦智勇1,(), 梁志坚1, 罗颖健1   
  1. 1. 530022 广西南宁市第三人民医院眼科
  • 收稿日期:2018-05-08 出版日期:2018-08-28
  • 通信作者: 秦智勇

Endoscopic dacryocystorhinostomy for the treatment of lacrimal obstructive disease observation

Zhiyong Qin1,(), Zhijian Liang1, Yingjian Luo1   

  1. 1. Depertment of Ophthalmology, Guangxi Nanning Third People's Hospital 530022 China
  • Received:2018-05-08 Published:2018-08-28
  • Corresponding author: Zhiyong Qin
  • About author:
    Corresponding author: Qin Zhiyong, Email:
引用本文:

秦智勇, 梁志坚, 罗颖健. 鼻窦内窥镜下泪囊鼻腔造孔术治疗慢性泪囊炎的临床观察[J]. 中华眼科医学杂志(电子版), 2018, 08(04): 170-174.

Zhiyong Qin, Zhijian Liang, Yingjian Luo. Endoscopic dacryocystorhinostomy for the treatment of lacrimal obstructive disease observation[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2018, 08(04): 170-174.

目的

探讨鼻窦内窥镜下泪囊鼻腔造孔术治疗慢性泪囊炎的临床疗效。

方法

纳入广西省南宁市第三人民医院2017年4月至2018年3月就诊的共53例慢性泪腺炎患者,均采取鼻窦内窥镜下泪囊鼻腔造孔术治疗,并分析患者术中的情况及治疗的效果。

结果

53例慢性泪囊炎患者经鼻窦内窥镜下泪囊鼻腔造孔术治疗,手术均顺利完成,无1例患者手术失败。治愈45例(45只眼),占84.9%;有效8例(8只眼),占15.1%,患者治疗总有效率100%。8例(8只眼)治疗有效患者泪道冲洗通畅,轻微溢泪。随访10个月,经鼻内镜检查,鼻腔泪囊吻合口愈合良好,部分患者呈喇叭状、针状、圆孔状或裂隙状吻合口,泪道冲洗见水流,随后逐渐缩小。最后1次随访自觉流泪症状明显改善且冲洗通畅2例(均为常规泪囊鼻腔吻合术后复发的患者);取管后失访的3例患者中2例取管后即泪道冲洗不通畅伴分泌物,l例冲洗通畅。经鼻内镜检查,全部患者鼻腔泪囊吻合口恢复良好。

结论

鼻窦内窥镜下泪囊鼻腔造孔术治疗慢性泪囊炎具有显著疗效,安全有效。

Objective

To analyze the clinical curative effect of dacryocystorhinostomy in the treatment of chronic dacryocystitis with endoscopic sinus endoscopy.

Methods

53 cases of chronic lacritis were randomly selected, all of them were treated with endoscopic sinus surgery, and the therapeutic effect was analyzed.

Results

53 cases of chronic lacritis were successfully completed by endoscopic sinus surgery, and none of the patients failed. The total effective rate of treatment was 100%, and 8 cases were treated effectively with the lacrimal duct flushing, with slight tears. After 10 months of follow-up, no complications occurred, and the anastomosis of the nasal cavity was restored with endoscopic examination.

Conclusion

The treatment of chronic dacryocystitis is effective and safe and effective in the treatment of chronic dacryocystitis with endoscopic sinus surgery.

图1 鼻窦内窥镜下切开泪囊的彩色照像 图A 显示在泪颌缝骨薄弱区以咬骨钳进入,咬除上颌骨额突;图B 显示以高速磨;图C 显示以镰状刀切开泪囊;图D 显示切口下方的泪囊壁展开,形成泪囊瓣
图2 鼻窦内窥镜下鼻腔泪囊造口彩色照像 术后患者恢复良好,随访10个月,经鼻窦内窥镜检查,鼻腔泪囊吻合口逐渐缩小
[1]
张宝根.鼻窦内窥镜下泪囊鼻腔造孔术治疗慢性泪囊炎临床观察[J].中国现代药物应用,2016,10(2):33-34.
[2]
韦理直,韦辉,黄锐,等.鼻内镜下泪囊鼻内造孔术治疗慢性泪囊炎的效果观察[J].微创医学,2016,11(1):48-49.
[3]
高双宝.鼻窦内窥镜下泪囊鼻腔造孔术治疗慢性泪囊炎的临床效果[J].世界最新医学信息文摘,2016,16(31):41-42.
[4]
Warren JF, Seiff SR, Kavanagh MC.Long-term results of external dacryocystorhinostomy[J].Ophthalmic Surg Lasers Imaging,2005,36(6):446-450.
[5]
Macewen CJ.Congenital nasolacrimal duct obstruction[J].Compr Ophthalmol Update,2006,7(2):79-87.
[6]
Kapadia MK, Freitag SK, Woog JJ.Evaluation and management of congenital nasolacrimal duct obstruction[J].Otolaryngol Clin North Am,2006,39(5):959-977.
[7]
Badhu B, Dulal S, Kumar S,et al.Epidemiology of Chronic Dacryocystitis and Success Rate of External Dacryocystorhinostomy in Nepal[J].Orbit,2005,24(2):79-82.
[8]
Sun X, Liang Q, Luo S,et al.Microbiological analysis of chronic dacryocystitis[J].Ophthalmic Physiol Opt,2005,25(3):261-263.
[9]
Marthin JK, Lindegaard J, Prause JU,et al. Lesions of the lacrimal drainage system:a clinicopathological study of 643 biopsy specimens of the lacrimal drainage system in Denmark 1910-1999[J].Acta Ophthalmol Scand,2010,83(1):94-99.
[10]
马丽. 泪小管炎伴结石形成4例[J].中国实用眼科杂志,2002,20(9):659.
[11]
Toti A.Nuovo metodo conservatore di cura radicale delle suporazioni chroniche del sacco lacrimale[J].Clin Mod Firenze,1904,10:385-389.
[12]
张勤修,吕红彬,杨慧,等.经鼻内镜下鼻腔泪囊吻合术研究[J].中国内镜杂志,2006,12(2):148-150.
[13]
闫静君,邢丽丽,蔡斌奇.泪囊鼻腔吻合术治疗慢性泪囊炎22例临床体会[J].国际眼科杂志,2009,9(6):1219.
[14]
Levin PS, Stormogipson DJ.Endocanalicular laser-assisted dacryocystorhinostomy.An anatomic study[J].Arch Ophthalmol,1992,110(10):1488-1490.
[15]
王在凡,王蕊.鼻窦内窥镜下泪囊鼻腔造孔术治疗慢性泪囊炎临床观察[J].临床研究,2016,24(4):119-120.
[16]
杜进涛,钟兵,刘亚峰,等.鼻内镜下修正性泪囊鼻腔造孔术治疗复发性泪囊炎的疗效观察[J].四川大学学报(医学版),2016,47(2):301-302.
[17]
郝友娟,李臻,孙金凤,等.鼻内窥镜下鼻腔泪囊造孔术联合泪道置管治疗慢性泪囊炎疗效观察[J].中国中医眼科杂志,2016,26(2):108-111.
[18]
罗飞.鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎的疗效观察[J].中国医药指南,2016,14(2):23-24.
[19]
刘勇智.鼻内窥镜下鼻腔泪囊造孔术联合泪道置管术治疗慢性泪囊炎疗效观察[J].医药前沿,2017,7(25):61-62.
[20]
Nuhoĝlu B, Ayyildiz A, Fidan V,et al.Transurethral electrovaporization of the prostate:is it any better than standard transurethral prostatectomy 5-year follow-up[J].J Endourol,2005,19(1):79-82.
[21]
徐志红,陈花兰.鼻内窥镜下鼻腔泪囊造孔术治疗与护理的研究[J].现代诊断与治疗,2016,27(21):4196.
[22]
任意明,蒋炜,邱敏,等.经泪小管980 nm激光泪囊鼻腔造孔术临床经验[J].中国实用眼科杂志,2014,32(12):1472-1474.
[23]
程婷玉,郑志生,徐潜生,等. 鼻内镜下鼻腔泪囊吻合术12例报告[J].中国眼耳鼻喉科杂志,2004,4(1):45.
[24]
杨平荪,许加军. 鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎36例[J].中国内镜杂志,2000,6(1):51.
[25]
郭卫红.鼻内镜下鼻腔泪囊造孔术治疗慢性泪囊炎临床观察[J].中西医结合心血管病电子杂志,2017,(34):40-41.
[26]
黄少鹏,吴丽华,郑昊,等.鼻内镜下泪囊鼻腔造孔术疗效分析[J].中国耳鼻咽喉头颈外科,2016,23(7):421-423.
[27]
樊建刚,陈力,李静娴,等.鼻内镜手术治疗鼻眼相关性疾病27例分析[J].实用医院临床杂志,2016,13(2):92-95.
[28]
Yigit O, Samancioglu M, Taskin U,et al.External and endoscopic dacryocystorhinostomy in chronic dacryocystitis:comparison of results[J].Eur Arch Otorhinolaryngol,2007,264(8):879-885.
[29]
Wu W, Yan W, Maccallum JK,et al.Primary treatment of acute dacryocystitis by endoscopic dacryocystorhinostomy with silicone intubation guided by a soft probe[J].Ophthalmology,2009,116(1):116-122.
[30]
Madge SN, Chan W, Malhotra R,et al.Endoscopic dacryocystorhinostomy in acute dacryocystitis:a multicenter case series[J].Orbit,2011,30(1):1-6.
[31]
Duggal P, Mahindroo NK, Chauhan A.Primary endoscopic dacryocystorhinostomy as treatment for acute dacryocystitis with abscess formation[J].Am J Otolaryngol,2008,29(3):177-179.
[32]
Singh M, Jain V, Singh SP,et al.Endoscopic dacryocystorhinostomy in cases of dacryocystitis due to atrophic rhinitis[J].J Laryngol Otol,2004,118(6):426-428.
[33]
Li EY, Wong ES, Wong AC, et al. Primary vs Secondary Endoscopic Dacryocystorhinostomy for Acute Dacryocystitis With Lacrimal Sac Abscess Formation:A Randomized Clinical Trial[J]. JAMA Ophthalmol, 2017, 135(12):1361-1366.
[34]
Tu Y, Qian Z, Zhang J, et al. Endoscopic Endonasal Dacryocystorhinostomy Combined with Canaliculus Repair for the Management of Dacryocystitis with Canalicular Obstruction[J]. J Ophthalmol,2015, 2015(4):1-7.
[35]
Wu S, Zhu G, Xiao D, et al.Modified intranasal endoscopic dacryocystorhinostomy in chronic dacryocystitis[J].Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2011,25(19):873-875.
[36]
Meyer A, Prasad KG, Antisdel J. Mycobacterium chelonae dacryocystitis after endoscopic dacryocystorhinostomy[J]. Allergy Rhinol (Providence),2014,5(2):87-90.
[37]
姚小春,黄海芬,刘小苓. 影响鼻内镜下鼻腔泪囊造口术疗效的因素分析[J]. 中国内镜杂志,2006,12(3):323-324.
[38]
李志辉. 新编眼科临床手册[M].北京:金盾出版社,1995:232.
[39]
康玲艳,康巍. 慢性泪囊炎的治疗及护理进展[J]. 中国实用护理杂志,2003,19(19):75-76.
[40]
李永强,张文山. 鼻内镜下泪囊鼻腔造孔术[J]. 中国耳鼻咽喉头颈外科,2005,12(1):33-34.
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