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泪囊瘘分先天性和后天性两种,先天性泪囊瘘是胚胎时面裂未能很好闭合,而后天性泪囊瘘多由急性泪囊炎脓肿破溃而致。以往对重症泪囊瘘的治疗多采用泪囊摘除术,泪道完整者,采用瘘管切除术。由于瘘管与周围组织多紧密粘连,术中瘘管分离困难,易误断瘿管造成残留,引起术后复发;对泪囊损伤较大;术后由于炎症反应而发生粘连,造成泪道阻塞等。笔者采用泪道插管辅以探针瘘管内支撑行瘘管切除术,治愈9例,现介绍如下:
Dacryocystostomy sub-congenital and acquired two kinds of congenital dacryocystorhoidostomy is an embryo when the fissure failed to close well, and then nature of the dacryocystitis and more by the acute dacryocystitis abscess rupture caused. In the past the treatment of severe lacrimal sac fistula use more lacrimal sac removal, lacrimal duct complete, the use of fistula resection. As the fistula and the surrounding tissue more adhesion, intraoperative fistula separation difficulties, easy to mistake the tube caused by residual, causing postoperative recurrence; greater damage to the lacrimal sac; postoperative adhesions due to inflammatory reactions, resulting in lacrimal duct obstruction. I used lacrimal duct intubation with pin fistula catheterization fistula resection, cure 9 cases, are as follows: