泪道引流管、再通管置入治疗慢性泪囊炎的临床观察

摘要

目的：观察泪道引流管、泪道再通管置入治疗慢性泪囊炎的临床疗效及并发症情况。方法回顾分析采用泪道引流管、再通管置入治疗的158例（204眼）慢性泪囊炎患者的临床资料。根据泪道置入物类型分为泪道引流管组（67例，81眼）和泪道再通管组（91例，123眼）。泪道引流管组置入泪道引流管，泪道再通管组置入泪道再通管。置管6个月后拔管并随访观察6个月，观察流泪、流脓、泪道通畅情况及并发症发生情况。结果泪道引流管组治愈42眼（51．85％），好转11眼（13．58％），无效25眼（30．86％），复发3眼（3．70％）。泪道再通管组治愈87眼（70．73％），好转18眼（14．63％），无效15眼（12．20％），复发3眼（2．44％）。泪道再通管组疗效明显优于泪道引流管组（χ2＝11．738，P ＜0．01）。并发症：泪道引流管组5例（5眼）术中发生鼻出血；5例（5眼）术后出现内眦部红肿、刺痛、异物感；4例（4眼）出现泪小点撕裂及短小泪小管撕裂；1例（1眼）出现下泪小管全长撕裂；2例（2眼）泪道引流管从内眦部脱出。泪道再通管组2例（2眼）术中出现鼻出血。结论泪道引流管、泪道再通管置入治疗慢性泪囊炎具有创伤小、手术时间短、术后恢复快、不留瘢痕等优点。泪道再通管置入治疗慢性泪囊炎临床疗效优于泪道引流管置入，且并发症少。%Objective To observe the clinical efficacy and complication of intubation of drainage and recanalization catheters in the lacrimal duct to treat chronic dacryocystitis.Methods Clinical data were collected from 158 patients (204 eyes) who underwent intubation of drainage or recanalization catheter in the lacrimal duct to treat chronic dacryocystitis be-fore retrospective analysis.These patients were divided into two groups according to the type of catheter inserted: a drainage catheter group (67 patients, 81 eyes) and a ductrecanalization catheter group (91 patients, 123 eyes).The catheters were placed for six months before follow -up visit for six months.Then, lacrimation, suppuration, obstruction of the lacrimal duct and complications were observed.Results After intubation of drainage catheter, 42 eyes (51.85%) were cured, 11 eyes (13.58%) were improved, while 25 eyes (30.86%) showed no change, and 3 eyes (3.70%) relapsed.In contrast, after intubation of drecanalization catheter, 87 eyes (70.73%) were cured, 18 eyes (14.63%) were improved, while 15 eyes (12.20%) showed no change, and 3 eyes (2.44%) relapsed.Group recanlization catheter produced superior effec-tiveness over Group drainage catheter (χ2 =11.738, P <0.01).As to complications, in Group recanalization catheter, 5 patients (5 eyes) presented epistaxis during surgery; 5 patients (5 eyes) showed swelling and felt itchy in the inner can-thus; 4 patients (4 eyes) reported canalicular and small lacrimal duct lacerations; 1 patient (1 eye) appeared full -length canalicular laceration; and 2 patients (2 eyes) manifested removal of drainage catheter from the inner canthus.Meanwhile, in Group recanalization catheter, 2 patients (2 eyes) presented epistaxis during surgery.Conclusion The use of intuba-tion of drainage and recanalization catheters in the lacrimal duct to treat chronic dacryocystitis is advantageous in small inci-sion, short duration of surgery and fast recovery, without any scar after surgery.Intubation of recanlization catheter can pro-duce better therapeutic efficacy than intubation of drainage catheter for chronic dacryocystitis, with less complication.