【摘要】 目的 观察鼻泪管支架植入术治疗慢性泪囊炎的临床疗效。方法 采用COOK公司生产的Song601型鼻泪管支架，在泪道和鼻腔黏膜表麻下经鼻腔逆行植入，治疗慢性泪囊炎185例（211眼）。术前泪道冲洗确定鼻泪管处阻塞，对泪囊无明显脓性分泌物的患者行泪道泛影葡胺造影，检查确定泪囊大小在2滴水以上。术后每日冲洗泪道1周，之后每月冲洗泪道1次。结果 经1～32个月，平均12.5个月的随访观察，211眼中，不流泪，冲洗泪道通畅167眼，占79.15%；流泪，冲洗泪道不通44眼，占20.85%。术后早期并发症；大部分患者术后泪囊部稍有疼痛感，一般在术后1周左右消失；1例（1眼）术后第3天冲洗泪道时发现泪囊陈旧性积血。术后远期并发症：常见的为鼻泪管支架蘑菇头部的肉芽组织阻塞，对鼻泪管支架阻塞的25眼重新从鼻腔取出支架，清除支架肉芽组织后重新支架植入后痊愈；鼻泪管支架从鼻腔自行脱出1眼。结论 鼻泪管支架植入术治疗慢性泪囊炎是一种新型的、简便、安全、有效的方法。
【关键词】 鼻泪管支架；慢性泪囊炎；介入治疗
Nasolacrimal stent for the treatment of chronic dacryocystitis
ZHOU Tai-ping，FANG Xu-lin.Xiamen Eye Center 361001，Xiamen，China
［Abstract］ Objective To observe the clinical outcome of nasolacrimal stent implant ation in patients with chronic dacrycystitis.Methods Two hundred and eleven eyes of 185 patients with chronic dacrycystitis were implanted with Song601 nasolacrimal stent via nasal cavity under the topical anesthesia.The blockade of lacrimal duct (LD) was confirmed by water douching the LD before the surgery.The size of two drops of water of lacrimal sac was required for procedure.If no discharge of abscess was confirmed，a meglumine diatrizoate graphy was performed.LD was douched daily for the first week of post-operation and once month thereafter.Results Patients were followed up from 1 to 32 months(mean 12.5 months).The symptoms of lachrymation were improved.The LDs of 167(79.15%) eyes were normal.The LDs of others(20.85%) were still blocked.The pain was found in most of patients in first week and disappeared later.The old hemorrhage was found in lacrimal sac in one patient.The most common complication was the formation of mushroom shape connective tissues，which could be removed and stent was reimplanted.Conclusion The implantation of nasolacrimal stent is a simple，safe and effective method to treat patient with chronic dacrycystitis.
［Key words］ nasolacrimal stent;chronic dacryocystitis;intervene therapy
慢性泪囊炎是临床上常见疾病，其传统有效的治疗方法是泪囊鼻腔吻合术，由于泪囊鼻腔吻合术手术创伤大、并发症多且面部留下瘢痕等缺点而往往不易被接受。近年来介入设备和技术的发展，给这一疾病提供了新的治疗手段和方法。我院自2003年3月开始，对185例（211眼）慢性泪囊炎患者使用COOK公司生产的Song601型鼻泪管支架植入术，取得较好的效果，现报告如下。
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