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1、实用放射学杂志2001年2月第17卷第2期95介入性塑料支架置入术治疗鼻泪管阻塞11112施海彬,李麟荪,陈惠珠,陈玉琴,卞春及(南京医科大学第一附属医院1放射科;2眼科,江苏南京210029)[摘要]目的:介绍鼻泪管阻塞的介入性塑料支架置入术并评价其疗效。方法:对23例患者的25个由泪囊炎引起阻塞的泪道置入Song601型塑料支架,阻塞部位均位于泪囊与鼻泪管交界处。按Song方法透视下将导丝由泪点顺行插入,再从鼻腔逆行引入支架。术前与术后行泪道造影,随访期均超过1年。结果:所有泪道支架均放置成功,术后造
2、影均显示通畅,1周后23个(92%)无溢泪,7个(28%)泪道于术后2～10个月溢泪复发,其中3个是由泪总管阻塞引起。3个阻塞的支架被取出,取出的支架内2个有肉芽组织,1个有粘液样物质。2个取出后仍不通,另一个取出后3周溢泪复发,将原支架重新置入后缓解。未出现严重并发症。结论:鼻泪管阻塞后可用介入性置入塑料支架治疗,随访1年以上疗效显著,安全性好,可作为首选治疗手段。[关键词]泪管阻塞;放射学,介入性;支架+[中图分类号]R777.22[文献标识码]A[文章编号]1002-1671(2001)02-009
3、5-04NasolacrimalDuctObstructionTreatedInterventionallywithPlasticStentsSHIHai-bin,LILin-sun,CHENHui-zhu,CHENYu-qing,BIANChun-jiDepartmentofRadiology,TheFirstAffiliatedHospital,NanjingMedicalUniversity,Nanjing210029[ABSTRACT]Objective:Tointroducethetechniq
4、uesofinterventionaluseofplasticstentsinthetreatmentofthenasolacrimalductobstruc2tionandtoevaluateitseffectiveness.Methods:Twenty-fiveplasticstentswereplacedin23patientswithepiphoraowingtocompleteobstructionatthejunctionbetweenthelacrimalsacandthenasolacri
5、malductafterchronicdacryocystitis.Thestentwasintroducedunderfluoroscopicguidancethroughthenasalcavityovertheguidewireinsertedthroughthesuperiorpunctum.Dacryocystographywasperformedbeforeandaftertheprocedure.Thefollow-upperiodineverycaseswasmorethan1year(r
6、ange,14～29months).Results:Stentplacementwastechnicallysuccessful,tearingstoppedimmediatelyinalllacrimalsystemswithoutanyseverecomplications.Thecompleteresolutionofepiphorawasdemonstratedin23systems(92%).Therewasrecurrence2～10monthsaftertheprocedurein7syst
7、ems(28%)duetoobstructionofstent(n=4)orobstructionofthecommoncanaliculus(n=3).Theone-yearpatencyratewas64%.Therewasgranulationtissuein2of3removedstentswithobstructionandmucoidmaterialinanotherstent,whichwasplacedinthesamesystemaftercleanedandsterilized.Con
8、clusion:Interventionalplacementofplasticstentintheobstr2uctednasolacrimalductisasimple,safe,andeffectiveinitialtherapy.[KeyWords]lacrimalductobstruction;radiology,interventional;stents鼻泪管阻塞主要由泪囊特发性炎症引起,表现为其中17个治疗时伴有
