涙管チューブ抜去後の菌検査

Bacterial flora from removed lacrimal stents

要約　目的：抜去した涙管チューブの菌検査の結果の報告。対象と方法：下鼻道法による涙囊鼻腔吻合術を行い，ヌンチャク型シリコーンチューブ（NST）を挿入した284例を対象とした。200例ではNSTの盲端を涙点側から抜去し（第1群），45例では盲端を下鼻道経由で抜去（第2群），39例では先端を切断したNSTを下鼻道から抜去した（第3群）。抜去したNSTの擦過物を培養し菌を検索した。結果：各群で40～73％の頻度で菌が検出された。第1群と第3群ではチューブ留置が2か月以上になると有意に増加した。耐性菌は第3群で多く，2か月以上で有意に増加した。結論：NSTの留置期間は2か月以内が望ましく，抜去はチューブの盲端を下鼻道から行うのがよい。

Abstract.　Purpose：To report the incidence and drug resistance of microorganisms cultured from removed lacrimal stents. Cases and Method：This study was made on 284 eyes that received dacryocystorhinostomy through the inferior meatus followed by insertion of nunchaku-style silicone tube（NST）. NST was removed via the lacrimal punctum in 200 eyes（Group 1）,via the inferior meatus in 45 eyes（Group 2）,and via the inferior meatus with the tip cut in 39 eyes（Group 3）. The removed NST was scrubbed and was cultured for microorganisms. Results：Microorganisms were cultured in 40％ to 73％ of samples depending on the mode of removal and duration of detention of NST. Incidence of positive culture increased in Group 1 and 3 after detention of NST longer than 2 months. Incidence of drug resistance was more frequent in Group 3 and increased significantly after detention longer than 2 months. Conclusion：The findings suggest that NST be retained for 2 months or less and that it be removed in the intact state through the inferior meatus.