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目的评价逆行鼻泪管插管术联合泪道冲洗治疗鼻泪管阻塞的疗效,探讨影响手术预后的因素。设计回顾性病例系列。研究对象鼻泪管阻塞患者186例(207眼)。方法对泪囊碘油造影确诊鼻泪管阻塞患者,采用泪道探通及逆行扩张鼻泪管后放置硅胶管手术,术后定期冲洗泪道,评价其疗效。主要指标手术后泪道冲洗情况。结果180例(201眼)成功植入硅胶管,手术成功率97.1%,术后定期冲洗泪道,3～12个月(平均6.4个月)拔管,拔管后3个月随访,167眼治愈(80.7%),好转25眼(12.1%),无效15眼(7.2%)。结论逆行鼻泪管插管术联合泪道冲洗是一种简单、安全、有效治疗鼻泪管阻塞的方法,其中病例选择、熟练泪道探通鼻泪管及术后定期冲洗泪道是手术成功的关键。
Objective To evaluate the curative effect of retrograde nasolacrimal duct intubation combined with lacrimal duct irrigation for the treatment of nasolacrimal duct obstruction and to explore the factors influencing the prognosis of surgery. Design retrospective case series. The study included 186 patients with nasolacrimal duct obstruction (207 eyes). Methods To diagnose patients with nasolacrimal duct obstruction diagnosed by lacrimal lipiodol angiography, silicone tube was put into operation after lacrimal passage exploration and retrograde expansion of nasolacrimal duct, and lacrimal duct was regularly rinsed after operation to evaluate the curative effect. The main indicators of lacrimal duct surgery after surgery. Results 180 cases (201 eyes) were successfully implanted silicone tube, the success rate was 97.1%. The lacrimal duct was regularly rinsed after operation, extubated 3 to 12 months (average 6.4 months), 3 months after extubation, and 167 eyes Cure (80.7%), improvement in 25 eyes (12.1%), ineffective in 15 eyes (7.2%). Conclusions Retrograde nasolacrimal duct intubation combined with lacrimal duct irrigation is a simple, safe and effective method for the treatment of nasolacrimal duct obstruction. Among them, case selection, proficient lacrimal tracing of nasolacrimal duct and regular lacrimal irrigation of lacrimal duct after operation are successful key.