解剖学报 ›› 2021, Vol. 52 ›› Issue (6): 945-949.doi: 10.16098/j.issn.0529-1356.2021.06.017

• 解剖学 • 上一篇    下一篇

复发性泪囊炎鼻腔泪囊解剖学特点及其在内镜下鼻腔泪囊吻合联合支架植入术中的应用

张守凯1,2 刘勤3 梁丹茹4 郭玉芬1,5*   

  1. 1. 兰州大学第二临床医学院,兰州 730000; 2. 甘肃省人民医院耳鼻咽喉头颈外科,兰州 730000; 3. 甘肃省人民医院眼科,兰州 730000;  4. 甘肃省人民医院干部保健门诊,兰州 730000; 5. 兰州大学第二医院耳鼻咽喉头颈外科,兰州 730030
  • 收稿日期:2020-04-09 修回日期:2020-09-02 出版日期:2021-12-06 发布日期:2021-12-06
  • 通讯作者: 郭玉芬 E-mail:guoyf2021@163.com
  • 作者简介:2020-06-10
  • 基金资助:
    甘肃省自然科学基金

Anatomic characteristics of the lacrimal sac in the nasal cavity of recurrent dacryocystitis and its application in endoscopic dacryocystorhinostomy combined with stent implantation

ZHANG Shou-kai1,2 LIU Qin3 LIANG Dan-ru GUO Yu-fen1,5*   

  1. 1.The Second Clinical Medical College, Lanzhou University, Lanzhou 730030, China; 2.Department of  Otolaryngology  Head  and  Neck  Surgery,  Gansu Provincial  Hospital, Lanzhou 730000, China; 3.Department of Ophthalmology,Gansu Provincial Hospital,Lanzhou 730000, China; 4.Outpatient  Department  of  Health  Care  for  Cadres,  Gansu Provincial  Hospital,  Lanzhou 730000  China; 5.Otolaryngology-Head Neck Surgery, Lanzhou University Seconel Hospital, Lanzhou 730030, China
  • Received:2020-04-09 Revised:2020-09-02 Online:2021-12-06 Published:2021-12-06
  • Contact: GUO Yu-fen E-mail:guoyf2021@163.com

摘要:

目的  内镜下观察鼻腔泪囊的解剖结构,采用鼻腔泪囊吻合术联合支架植入方式治疗慢性复发性泪囊炎,并观察其疗效。   方法  收集2010年1月至2019年1月期间就诊于甘肃省人民医院耳鼻咽喉头颈外科的已行传统内镜下鼻腔泪囊吻合术后再次复发的慢性泪囊炎患者30例,共计30只眼,予以再次行内镜下鼻腔泪囊吻合术,术中联合支架植入术,术后3个月拔出泪道支架,观察患者术后流泪症状,冲洗泪道判断泪道阻塞情况,随访期为12个月。   结果  随访至12个月时,30例患者14只眼无诉流泪,溢泪,冲洗泪道通畅,鼻内镜下观察见造瘘口通畅,造瘘口无明显缩小;30例12只眼无诉流泪,溢泪,冲洗泪道通畅,但可见造瘘口缩小;4只眼可见造瘘口旁肉芽增生,再次堵塞造瘘口,治疗整体有效率为87%。   结论  内镜下鼻腔泪囊吻合术联合支架植入是治疗慢性复发性泪囊炎一种有效方法,临床效果良好。

关键词: 复发性泪囊炎, 支架植入术, 内镜下鼻腔泪囊吻合术, 解剖学,

Abstract:

Objective  To observe the efficacy of endoscopic nasal dacryocystoma anastomosis combined with stent implantation in the treatment of chronic recurrent dacryocystitis.    Methods  Thirty patients (30 eyes) with chronic dacryocystitis who had relapsed after traditional endoscopic nasal dacryocystorhinostomy were hospitalized in the Department of Otolaryngology Head  and Neck Surgery department of Gansu Provincial People’s Hospital from January 2010 to January 2019. Nasal lacrimal anastomosis under endoscope, intraoperative combined stent implantation, 3 months after operation, the lacrimal duct stent was removed, the patient’s tearing symptoms were observed, the lacrimal duct was flushed to determine the lacrimal duct obstruction, and the follow-up period was 12 months.    Results  Twelve months of follow-up to 12 months, 14 eyes of 30 patients had no complaints of tearing, tearing, and lacrimal tract flushing; The ostomy fistula was unobstructed under nasal endoscope and the fistula was not significantly reduced. There was no complaint of tears in the eyes, tears overflowed, and the lacrimal duct was flushed, but the fistula opening was reduced.;Four eyes showed granulation hyperplasia next to the fistula, which blocked the fistula again. The overall effective rate was 87%.    Conclusion  Endoscopic dacryocystorhinostomy combined with stent implantation is an effective method  for the treatment of chronic recurrent dacryocystitis with good clinical result .

Key words: Recurrent dacryocystitis, Stent implantation, Endoscopic dacryocystorhinostomy, Anatomy, Human

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