【摘要】  目的：观察泪道探通配合插管留置术治疗泪道阻塞的手术疗效，分析影响疗效的因素。 方法：采用泪道探通配合插管留置术治疗60例（90眼）泪道阻塞患者，术后3mo拔管，随访6mo，将阻塞部位不同和既往不同治疗史的疗效分别进行对比分析。结果：阻塞部位在泪小管，泪总管和鼻泪管的成功率分别为85.7％，75.8％，53.5％。经χ 2检验，阻塞部位在泪小管与在泪总管的手术疗效相同（P ＞0.05），阻塞部位在鼻泪管的手术疗效均低于阻塞部位在泪小管或在泪总管的 （P ＜0.05）。既往做过泪道激光手术疗效均低于未做过手术或曾做过泪道探通配合插管术（P ＜0.05）。曾做过泪道探通配合插管术再次手术不影响疗效（P ＞0.05）。结论：泪道探通配合插管留置术治疗泪道阻塞经济，简单，方便，治疗泪小管与泪总管阻塞效果好，手术失败再次手术仍有价值，但不适合治疗泪道激光手术失败后的病例。

    【关键词】  泪道探通；插管留置术

    Efficacy of lacrimal passage probing surgery associated with tube retaining

    Wen Chen, Yi-Zhen Hu, Yu-Kan Huang

    Department of Ophthalmology, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China

     AbstractAIM: To evaluate the therapeutic efficacy of lacrimal passage probing surgery with the tube retaining on obstructive diseases of lacrimal duct and to retrospectively analyze the reasons of the surgery outcome. METHODS: Ninety eyes of 60 cases with obstructive diseases on lacrimal duct were treated by lacrimal passage probing surgery with tube retaining. The tube was removed at postoperatively 3 months. The follow-up period was 6 months. Therapeutic effects on different obstructive parts and different operation histories were compared.RESULTS: The curative rates on obstruction of lacrimal canaliculus, lacrimal common canaliculus and nasolacrimal duct were 85.7%, 75.8% and 53.5%, respectively. Statistical analyses were performed by using Chi-square test. There was no significant difference on the therapeutic effect between obstruction of lacrimal canaliculus and lacrimal common canaliculus (P＞0.05). The therapeutic effect on obstruction of nasolacrimal duct was significantly lower than that on obstruction of lacrimal canaliculus and lacrimal common canaliculus (P＜0.05). The therapeutic effect on patients with the history of lacrimal plastic operation with laser was significantly lower than that on those without the history of operation or those with the history of probing surgery with tube retaining (P＜0.05). History of probing surgery with or without the tube stay had no influence on the therapeutic effect of re-operation (P＞0.05).
 CONCLUSION: Lacrimal passage probing surgery associated with tube retaining is an economical, simple and facile method for lacrimal passage obstruction, and the re-operation was still of certain value except for the failure cases after lacrimal plastic operation with laser.

    · KEYWORDS: lacrimal passage probing surgery; tube retaining

    0引言

    获得性器质性泪道阻塞或狭窄虽然不是很严重的疾病，但由此引起的泪溢给患者带来持续性身体上的不适感和美容上的缺陷，长期的泪液浸渍可引起慢性结膜炎，眼睑或面部的湿疹性皮炎，患者不断揩拭眼泪可导致眼睑外翻，从而更加重泪溢症状。治疗泪道阻塞的方法有许多种，其中泪道探通配合插管留置术由于操作简单易行，费用低廉，并且不需要特殊的设备和材料而被广大基层医院所采纳。本文对2000-01/2003-12于我院进行的60例（90眼）泪道探通配合插管留置术的患者进行随访观察，回顾性分析了影响手术疗效的因素，为临床工作中手术前评估术后手术效果提供参考依据。

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