目的 探讨外路泪囊鼻腔吻合或联合泪小管置管治疗泪囊囊肿的临床效果.方法 对2006年7月至2012年12月在绍兴市人民医院眼科就诊的泪囊囊肿患者23例进行了鼻腔泪囊吻合术或联合泪小管置管治疗,术后随访6个月至18个月,观察疗效.结果 共有23例泪囊囊肿患者接受鼻腔吻合术或联合泪小管置管术,其中治愈16例,有效5例,无效2例,无效者需在泪道内窥镜下进一步处理.结论 外路鼻腔泪囊吻合术或联合泪小管置管治疗泪囊囊肿成功率高,是目前治疗泪囊囊肿的较好手术方法.

Objective To discuss the treatment effect for external dacryocystorhinostomy or with putting silicone intubation in lacrimal ductule for lacrimal sac cyst.Methods A total of 23 cases with lacrimal sac cyst underwent external dacryocystorhinostomy with putting silicone intubation in lacrimal ductule,were followed up 6 to 18 months.Results After the follow-up of 6 to 18 months,curing were 16 cases,valid 5,invalid 2.Conclusions External dacryocystorhinostomy or combination with putting silicone intubation in lacrimal ductule can increase the surgical success rate for lacrimal sac cyst is a good surgical method for treating lacrimal sac cyst.

目的：探讨改良式泪囊鼻腔吻合术联合泪道置管治疗慢性泪囊炎合并泪管狭窄或阻塞的临床疗效。 方法：回顾性分析2010-07/2011-09在我院行改良式泪囊鼻腔吻合术联合泪道置管治疗56例慢性泪囊炎合并泪管狭窄或阻塞患者。 结果：术后3 mo拔管后行泪道冲洗全部通畅，随访2 a后有效率达95%。 结论：改良式泪囊鼻腔吻合术联合泪道置管治疗慢性泪囊炎合并下泪管狭窄或阻塞手术操作简便，成功率高。

AlM: To discuss the efficacy of modified dacrocystorhinostomy with intubation in the treatment of chronic dacryocystitis combined with lacrimal duct narrow or obstruction. METHODS: Retrospective analysis of 56 patients who underwent modified dacrocystorhinostomy with intubation in our hospital from July 2010 to September 2011. RESULTS: All patients underwent the extubation of lacrimal and catheters irrigation, the patency rate was 95% at 2a after operation. CONCLUSlON: Modified dacryocystorhinostomy combined with intubation is a effective method for chronic dacwocystitis combined with lacrimal duct obstruction, which has simple operative procedure, high success rate.

目的：探讨腰穿置管引流术联合高压氧治疗外伤性蛛网膜下腔出血（tSAH）的疗效。方法将165例tSAH 患者按随机数字表法分为3组：联合治疗组58例，早期（伤后12～24 h）行腰大池持续脑脊液外引流术，并尽早行高压氧治疗；腰穿置管组54例，早期行腰大池持续脑脊液外引流术；高压氧治疗组53例，仅采用高压氧治疗，不行腰椎置管引流脑脊液。所有患者留置引流管＜2周；高压氧治疗每日1次，10 d 为1疗程，共完成2个疗程。对3组患者头痛及意识障碍持续时间、脑积水及继发癫痫的发生情况及预后（恢复良好、轻度残疾、重度残疾、植物生存、死亡）进行比较。结果联合治疗组患者意识障碍、头痛持续时间及并发症（脑积水、继发癫痫）发生例数均显著少于腰穿置管组及高压氧治疗组，预后明显好于腰穿置管组及高压氧治疗组（均 P ＜0．05）。结论腰穿置管引流术联合高压氧治疗 tSAH 能尽快地缓解患者临床症状，有效地降低脑积水、癫痫等严重并发症的发生，显著改善预后，是 tSAH 有效的治疗措施。

Objective To investigate the efficacy of continuous lumbar drainage combined with hyperbaric oxygen therapy in the treatment of traumatic subarachnoid hemorrhage(tSAH).Meth-ods A total of 165 patients with tSAH were randomly treated with continuous lumbar cerebro-spinal fluid drainage 12-24 hours after injury(lumbar drainage group,n=54),hyperbaric oxygen therapy(hyperbaric oxygen therapy group,n=53),or their combination(combination group,n=58).The indwelling drainage tube was placed for <2 weeks,and hyperbaric oxygen therapy was performed once daily for 10 days as a course of treatment.After 2 courses of treatment,the dura-tion of headache and conscious disturbance,incidence of hydrocephalus and secondary epilepsy, and prognosis(good recovery,mild disability,severe disability,vegetative survival and death)were compared among the three groups.Results Compared with lumbar drainage group or hyperbaric oxygen therapy group,the duration of headache and conscious disturbance was sh

目的 总结分析经泪小管980 nm激光泪囊鼻腔造孔术的临床经验.方法 回顾于2011年4～10月在成都军区总医院眼科经泪小管980 nm激光泪囊鼻腔造孔联合置管术11例,其中单纯鼻泪管阻塞8例,常规泪囊鼻腔吻合术后复发者3例;术后随访4～19个月,记录手术操作情况,观察手术效果和并发症情况.结果 术中骨孔径大小约3 mm,4例次骨孔出口位置不当;取管后8例次冲洗有分泌物,6例次出现泪小管和(或)泪总管狭窄或阻塞;流泪症状明显改善且冲洗通畅者3例.结论 有报道经泪小管980 nm激光泪囊鼻腔造孔联合置管术成功率较高,但需要一定的经验和技巧保证足够大的骨孔及合适的位置,避免泪总管热损伤.

Objective To sum up the experience of transcanalicular 980nm laser-assisted dacryocystorhinostomy.Methods Retrospective reviewed 11 cases whom underwent transcanalicular laser-assisted dacryocystorhinostomy combined silicone intubation stenting,including 8 primary nasolacrimal duct obstruction and 3 failed external dacryocystorhinostomy.Follow-up time was 5-17 months.Surgery operation and complication were recorded.Results The size of osteotomys were about 3mm and 4 osteotomys were out of good place.Complications included 8 dacryocystitis,and 6 stenosis or obstruction of lacrimal ductule or common canalicular.Significant improvement of epiphora was achieved in 3 cases at last follow-up.Conclusions The transcanalicular 980nm laser-assisted dacryocystorhinostomy have been reported achieve satisfied success rate.However,experiences are needed for adequate osteotomy size,good location of ostrotomy,avoiding common canalicular thermal injury.

目的 研究磷酸钛氧钾(KTP)泪道激光联合泪道置管对复发性鼻泪管阻塞的治疗效果.方法 对门诊复发性鼻泪管阻塞54例(75眼)的治疗结果进行回顾性分析,根据是否选择置管,分为置管组(A组)24例(35眼)和非置管组(B组)30例(40跟)两组.结果 术后A组成功率为45.71％,B组成功率为15.0％,两组比较差异有统计学意义(x2=8.495,P=0.005).结论 对于复发性泪道阻塞予以再次激光且联合泪道置管术有一定疗效,改善了溢泪情况.

Objective To investigate the clinical efficacy of KTP laser combined with intubation for recurrent nasolacrimal duct obstruction.Methods This medical records of 75 eyes of 54 patients with recurrent nasolacrimal duct obstruction were retrospectively reviewed.All cases were divided into two groups.Group A (35 eyes of 24 cases) was treated by KTP laser combined with intubation.Group B (40 eyes of 30 cases) only underwent KTP laser treatment.The outcome of two groups was compared.Results The surgical success rates of group A and group B were 45.71％ and 15.0％,respectively.The difference of success rate was statistically significant(x2 =8.495,P =0.005).Conclusion KTP laser combined with intubation has good clinical efficacy for recurrent nasolacrimal duct obstruction.