【摘要】 目的 探讨泪囊鼻腔吻合术后复发的原因和手术方法。 方法 对1999年1月-2009年10月因泪道阻塞行泪囊鼻腔吻合术后3个月以上复发的47例患者，行再吻合术，术中仔细分离切除瘢痕及肉芽，尽量做双瓣吻合。 结果 本组50只眼，术后随访3个月～2年，成功49只眼，1例再阻塞，治愈率98%。 结论 首次手术失败的主要原因是骨孔过小，吻合口粘连，泪囊太小或萎缩，解剖层次不清和手术操作粗暴导致术中出血等。再次吻合手术治疗效果满意。【Abstract】 Objective To explore the reasons of recurrence and the operative method for re-blockage after dacryocystorhinostomy. Methods Forty-seven patients with dacryocystorhinostomy who were recurred after 3 months were included from January 1999 to October 2009. All patients underwent re-anastomosis. The operation required careful separation and resection of scar and granulation, and performed anastomosis with double valve as far as possible. Results All patients were followed up for three months to two years. Operations were successful in 49 eyes of total 50 eyes, and re-obstruction in one case with a cure rate of 98%. Conclusion The major reasons for the failure of the first operation include too small bone hole, anastomotic adhesions, too small or atrophy of lacrimal sac, unclear anatomy and surgical gross bleeding. The best treatment is surgical re-anastomosis.
目的:探讨鼻内窥镜在泪囊鼻腔吻合术后的应用。方法:343例436眼实施泪囊鼻腔吻合术,术后结合鼻内窥镜检查。结果:术后随访1～12月,手术治愈好转率为96.33%。结论:鼻内窥镜对泪囊鼻腔吻合术后吻合口行检查及修复,能很好的提高泪囊鼻腔吻合术成功率。