微创结膜囊鼻腔吻合术治疗完全性上下泪小管阻塞

Minimally invasive conjunctivorhinostomy for the treatment of complete bicanalicular obstruction

摘要:

目的：探讨微创结膜囊鼻腔吻合术治疗完全性上下泪小管阻塞的有效性，并评价这种手术的优势、术后并发症及患者满意度。

方法：选取完全性上下泪小管阻塞患者22例22眼作为研究对象，施行微创结膜囊鼻腔吻合术。术后随访3～27mo，记录患者的人口学数据、手术时长、义管长度、随访时间、义管的通畅情况、术后并发症、对手术是否满意，分析数据结果，评价微创结膜囊鼻腔吻合术的临床意义。

结果：手术总体成功率为95%(21/22)，患者总体满意度为68%(15/22)。术后并发症包括鼻腔肉芽组织包裹义管下口2例(9%)，中鼻甲黏膜堵塞义管下口3例(14%)，鼻黏膜覆盖义管下口1例(5%)，义管管腔被分泌物堵塞5例(23%)，异物不适感10例(45%)，干眼2例(9%)，鼻腔分泌物逆流入结膜囊8例(36%)。

结论：微创结膜囊鼻腔吻合术可有效治疗完全性上下泪小管阻塞。手术方法操作简单，成功率高，手术时间短，组织损伤小，并发症少，且不遗留面部皮肤瘢痕。

Abstract:

AIM: To investigate the effectiveness of minimally invasive conjunctivorhinostomy for complete bicanalicular obstruction, and to evaluate the advantages, complications, and degree of satisfaction after this technique.

METHODS: Twenty-two patients(22 eyes)with complete bicanalicular obstruction were selected as the research subjects, all patients were treated by minimally invasive conjunctivorhinostomy. The post-operation follow-up lasted for 3-27mo. Medical records were reviewed for demographic data, surgical time, length of the tubes, duration of follow-up, patency of the tube, postoperative complications, whether satisfied or dissatisfied with this procedure. Meanwhile, the data was analyzed for evaluating the clinical efficacy of minimally invasive conjunctivorhinostomy.

RESULTS: The overall operative success rate was 95%(21/22), and the overall patient satisfaction was 68%(15/22). The post-operation complications included: granulation tissue proliferation of the lower end of the tube 2 cases(9%), middle turbinate blocked the opening of tube 3 cases(14%), nasal mucosa covering the opening of tube 1 case(5%), the tube was blocked by secreta 5 cases(23%), foreign body sensation 10 cases(45%), dry eye 2 cases(9%), regurgitation of nasal secreta discharge 8 cases(36%).

CONCLUSION: Minimally invasive conjunctivorhinostomy can treat the complete bicanalicular obstruction. This operation method is characterized by simplicity, high success rate, short operative time, less tissue trauma, less complications, without facial scarring, and it is worth clinical promotion.