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改良Ritleng泪道导管治疗泪道阻塞的临床观察 被引量:1

Modified ritleng intubation system for treatment of lacrimal duct obstruction
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摘要 目的描述对Ritleng泪道导管系统原有设计进行改良的可行性,并评价其疗效。方法采用镍钛形态记忆导丝等对Ritleng泪道导管进行改良,并应用于25例(26眼)严重阻塞性溢泪(Munk分级法,3~4级)。进行泪道诊断试验,随访评估泪道解剖及功能性开放。观察镍钛导丝引出鼻腔的方式。随意选择2例(2眼)进行计算机断层扫描泪道造影( computed tomography-dacryocystography, CT-DCG)。结果拔管后随访4~12月,平均(7.1±3.7)月。拔管后末次随访,24眼(92.31%)溢泪症状完全消失。在经52个泪点的52次镍钛导丝导引操作中,46次(88.46%)镍钛导丝自动弹出鼻孔或进入鼻前庭。CT—DCG显示导管内造影剂充盈均匀、管腔开放。结论改良的导管系统,操作简便,有较高的泪道再涌室. Objective To describe the technical properties of the modified Ritleng intubation system and to verify its clinical effectiveness for lacrimal duct obstruction. Methods Nickel-titanium thread guide was adopted to modify the original Ritleng intubation system. The modified stents were successfully intubated in 26 eyes of 25 patients with severe obstructive epiphora (grade 3 or worse on Munk's scale). Diagnostic tests were conducted to identify the anatomical and functional patency of the lacrimal duct. We recorded how the nickel-titanium thread guides extruded from the nostrils. 2 cases were randomly selected for computed tomographydacryocystography (CT-DCG). Results The follow-up periods after extubation ranged from 4 months to 12 months (mean follow-up, 7.1± 3.7 months). At the last follow-up after extubation, complete resolution of epiphora was achieved in 24 eyes (92.31%). In 46 ( 88.46% ) of 52 intubation procedures through 52 individual punctae, the nickel-titanium thread guides spontaneously emerged out of the nostrils or in the nasal fossae. CT-DCG demonstrated thatthe lumens of the stents were patent and evenly filled with contrast media. Conclusion The modified intubation set was technically easy to be maneuvered with a favorable rate of recanalization.
出处 《眼外伤职业眼病杂志》 2010年第8期570-574,共5页 Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries
关键词 泪道狭窄 泪道阻塞 Ritleng泪道导管 计算机断层扫描泪道造影 镍钛形态记忆合金 lacrimal stenosis lacrimal obstruction Ritleng intubation computed tomography-dacryocystography nickel-titanium shape-memory alloy
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