鼻泪管支架植入术125例临床观察

目的观察鼻泪管支架植入术治疗慢性泪囊炎和鼻泪管阻塞的效果。方法鼻泪管支架植入术125例（135眼）。术前诊断为慢性泪囊炎或鼻泪管阻塞等。采用中南大学湘雅二院研制的鼻泪管支架。以空心泪道探针经上泪小管、泪总管、泪囊、鼻泪管探通入下鼻道，将引导钢丝插入空心探针，从前鼻孔钩出，将鼻泪管扩张器、鼻泪管支架、支架推注器先后穿入钢丝，经鼻泪管开口逆行扩张鼻泪管及泪囊，将支架逆行推入鼻泪管及泪囊。术后定期冲洗泪道。结果随访6-19个月，治愈率91．85％。结论鼻泪管支架植入术疗效与鼻腔泪囊吻合术相当，且微创安全。术后定期泪道冲洗有助于减少支架阻塞的发生率。

Clinical observation of 125 cases of nasolacrimal stent implantation

Objective To observe the efficacy of nasolacrimal stent implantation for patients with chronic dacryocystitis and nasolacrimal duct obstruction. Methods From January 2008 to February 2009,135 eyes of 125 cases of nasolacrimal stent implantation have been performed in our hospital, and the major diagnoses were chronic dacryocystitis and nasolacrimal duct obstruction. The nasolacrimal stent was developed by the second Xiangya hospital, the operation method was to probe via lacrimal passages into nasal cavity, then the nasolacrimal duct and lacrimal sac were dilated and the stent was placed retrogradely in them.Lacrimal system was irrigated termly after operation, and the post-operative effects and the inter- and postoperative complications were observed. Results After 6 to 19 months' follow-up, the success rate was 91. 85% . The symptom of epiphora didn' t lighten in 2 earlier post-operative eyes ( 1.48% ) , but the lacrimal duct were unblocked after repeating irrigation. The symptom of epiphora recurred in 9 terminal post-operative eyes (6.67% ) , of them 8 eyes were diagnosed with chronic dacryocystitis, and the lacrimal ducts were unblocked after repeating irrigation. The inter-operative complications included mild epistaxis and difficulties in implanting the stent, and the post-operative complication was mainly stent obstruction by secretion. Conclusion Nasolacrimal stent implantation has the same effect with dacryocystorhinostomy, has less wound, simple, so it is worth being used more widely in clinic. Termly lacrimal system irrigation helps to reduce the rate of stent occlusion occurrence after operation.