泪小点引流联合泪道激光置管治疗急性泪囊炎并发脓肿

江明洁，赵贵阳

作者单位：(210006)中国江苏省南京市，南京医科大学附属南京医院(南京市第一医院) 眼科



·临床报告·

泪小点引流联合泪道激光置管治疗急性泪囊炎并发脓肿

江明洁，赵贵阳

作者单位：(210006)中国江苏省南京市，南京医科大学附属南京医院(南京市第一医院) 眼科

Puncta drainage and laser dacryocystoplasty with silicone tube stents for acute dacryocystitis complicated by abscess formation

Ming-Jie Jiang, Gui-Yang Zhao

Department of Ophthalmology,Nanjing Hospital Affiliated to Nanjing Medical University，Nanjing 210006, Jiangsu Province, China

Correspondence to: Ming-Jie Jiang. Department of Ophthalmology,Nanjing Hospital Affiliated to Nanjing Medical University，Nanjing 210006, Jiangsu Province, China. Jiangmj100@aliyun.com

Received：2015-12-11Accepted：2016-03-04

Abstract

•AIM:To observe the clinical efficacy of puncta drainage and Nd:YAG laser dacryocystoplasty with silicone tube stents for acute dacryocystitis complicated by abscess formation.

•METHODS:A total of 28 patients who were diagnosed as acute dacryocystitis with abscess formation during the period from December 2011 to December 2014 were treated with puncta drainage and Nd:YAG laser dacryocystoplasty with silicone tube stents. The silicone tube stents were removed after 6mo, and the patients were followed up for at least 6mo. The situation of epiphora, suppurating, abscess absorption and other complications were observed.

•RESULTS:In the first 6mo postoperatively, improvement or absence of the epiphora, unobstructed lacrimal duct occurred in all the patients, and there was no recurrence of the lacrimal inflammation or pyorrhea. The silicone tube stents were removed at 6mo postoperatively, the follow-up period was 6mo after removal of the silicon tube stents. There were 13 eyes cured and 7 eyes improved, and the total effective rate was 71%. No improvement was observed in 8 eyes, accounting for 29%.

•CONCLUSION:The puncta drainage and Nd:YAG laser dacryocystoplasty with silicone tube stents is an effective treatment for acute dacryocystitis complicated by abscess formation. But the recurrence rate is high, and another surgery is needed in such cases.

KEYWORDS:•puncta drainage; Nd:YAG laser dacryocystoplasty;silicone tube stents; acute dacryocystitis; dacryocust abscess

Citation:Jiang MJ, Zhao GY. Puncta drainage and laser dacryocystoplasty with silicone tube stents for acute dacryocystitis complicated by abscess formation.GuojiYankeZazhi(IntEyeSci) 2016;16(4):770-772

摘要

关键词：泪小点引流；泪道激光；泪道引流管；急性泪囊炎；泪囊脓肿

引用：江明洁，赵贵阳.泪小点引流联合泪道激光置管治疗急性泪囊炎并发脓肿.国际眼科杂志2016;16(4):770-772

0引言

急性泪囊炎是由于毒力强的细菌感染所致，大多为慢性泪囊炎的急性发作，也可以无溢泪史而突然发生。局部炎症明显，早期治疗为局部和全身使用抗生素、热敷等[1]。急性泪囊炎常易形成脓肿，病程长且痛苦。我科目前采用泪小点引流联合Nd:YAG泪道激光成形术加泪道再通管治疗急性泪囊炎并发脓肿患者，取得一定疗效，现报告如下。

1对象和方法

1.1对象回顾性分析了2011-12/2014-12我科用泪小点引流联合Nd:YAG泪道激光成形加泪道再通管置入术治疗急性泪囊炎并发泪囊脓肿患者28例28眼，其中男8例8眼，女20例20眼，年龄43～82岁，病程1mo～2a。其中5例曾行泪囊区皮肤面脓肿切开引流未愈。手术器材：脉冲Nd：YAG激光泪道治疗机TDJ-100，激光波长1064nm；激光能量：20～50mJ;脉冲频率：10～50Hz，光纤直径0.4mm，脚踏开关控制。一次性泪道再通管：包括泪道扩张管和再通管，泪道用记忆导丝，9号泪道探针，泪点扩张器等。

1.2方法

1.2.1 术前治疗全身口服或静脉应用抗生素3～7d，局部抗生素眼液每天4～6次点眼至急性炎症症状好转，脓肿局限。……