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目的 :报告 2 75例 (310只眼 )慢性泪囊炎接受鼻内镜下经鼻行泪囊鼻腔造孔术治疗后 ,9只眼患者自然泪道复通现象。方法 :2 75例 (310只眼 )慢性泪囊病变患者接受鼻内镜下泪囊鼻腔造孔术 ,手术在局部或全身麻醉下进行。术后随访包括鼻内镜检查处理、泪道冲洗及鼻腔局部应用糖皮质激素。结果 :随访 3～ 6 0个月 ,治愈率 75 3% ,好转率 11 7% ,总有效率为 87 0 % ,无效为 13 0 %。 2 75例 (310只眼 )中 ,9只眼术后 1年泪囊鼻腔造孔瘢痕闭锁 ,冲洗液自泪囊鼻腔自然开口流出。结论 :慢性泪囊炎泪道下端阻塞并非完全不可逆 ,在手术造孔、建立泪液旁路引流途径之后 ,原来阻塞的鼻泪管局部粘膜炎症可以缓解 ,重新发挥泪液排出功能。
OBJECTIVE: To report 2 75 cases (310 eyes) of chronic dacryocystitis received nasal endoscopic nasal dacryocystorhinostomy, nine eyes of patients with natural lacrimal duct multiple pass phenomenon. METHODS: Twenty-seven patients (310 eyes) with chronic lacrimal disease underwent nasal endoscopic dacryocystorhinostomy. The procedure was performed under local or general anesthesia. Postoperative follow-up included endoscopic examination, lacrimal irrigation, and nasal topical glucocorticoid use. Results: The follow-up ranged from 3 to 60 months. The cure rate was 75.3%, the improvement rate was 117%, the total effective rate was 87% and the ineffectiveness was 130%. Of the 75 cases (310 eyes), 9 eyes were blocked at 1 year postoperatively with dacryocystorhinostomy and irrigation fluid was removed from the natural opening of the dacryocyst nasal cavity. CONCLUSION: Chronic dacryocystitis lacrimal duct obstruction is not completely irreversible. After the procedure of laparotomy and establishment of lacrimal fluid bypass, the original obstructed nasolacrimal duct mucosa inflammation can be relieved and the lacrimal fluid discharge function can be restarted.