双泪小管鼻泪管插硅胶管联合泪小管断裂吻合术的疗效观察  

Curative effects of double-canalicular and nasolacrimal silicone intubation combined with canalicular laceration anastomosis

作　　者：王宇冉[1] 王梦华[1] 侯习武[1] 雷方[2] 赵晓华[1] 

机构地区：[1]郑州大学第四附属医院眼科,河南省郑州市450044 [2]郑州大学第二附属医院,河南省郑州市450014

出　　处：《眼科新进展》2009年第10期781-782,共2页Recent Advances in Ophthalmology

摘　　要：目的观察双泪小管-鼻泪管插硅胶管联合泪小管断裂吻合术的疗效,寻求治疗泪小管断裂更合理的方法。方法收集26例(26眼)外伤性泪小管断裂患者,其中下泪小管断裂22例,上下泪小管同时断裂4例,所有患者采用双泪小管-鼻泪管插硅胶管术,以硅胶管作支撑,进行泪小管断端显微吻合。术后常规抗炎治疗,术后7d拆线,2个月时拔管。结果26例患者中,有2例术后出现吻合口哆开,再次吻合后创面愈合良好。术后2个月拔管时,无溢泪、泪小点裂伤、眼睑畸形、硅胶管脱落发生。随访5～18个月,全部患者泪小点复位良好,泪道冲洗通畅,23例患者无溢泪,治愈率为88.5%;3例患者有溢泪,好转率为11.5%。结论双泪小管-鼻泪管插硅胶管联合泪小管断裂吻合术,手术成功率高,并发症少,是治疗外伤性泪小管断裂的理想方法。Objective To explore the rational way for canalicular laceration by observing the curative effects of double-canalicular and nasolacrimal silicone intubation combined with canalicular laceration anastomosis.Methods Double canalicular and nasolacrimal silicone intubation was taken in 26 patients（26 eyes） with traumatic canalicular laceration,including 22 patients with inferior canalicular laceration and 4 patients with superior and inferior canalicular laceration.The broken ends of lacrimal ductule were supported by silicone tube and anastomosed under microscope.Traditional anti-inflammatory treatment was taken postoperatively,suture was taken out at postoperative 7 days,and extubation was done at postoperative 2 months.Results In 26 cases,there were 2 cases with ruptured anastomotic stoma postoperatively,and the wound surface was healed well after anastomosed again.When extubation was done at postoperative 2 months,there was no epiphora,laceration of lacrimal point,malformation of eyelid or shedding of silicione tube.After following up for 5 months to 18 months,the lacrimal point of all patients were with good reposition,lacrimal passages were with easy and smooth douche.There were 23 patients without epiphora,the curative rate was 88.5%;Three patients were with epiphora,the improvement rate was 11.5%.Conclusion Double-canalicular and nasolacrimal silicone intubation combined with canalicular laceration anastomosis is a rational way for traumatic canalicular laceration with high successful rate and few complications.

关 键 词：双泪小管-鼻泪管插硅胶管 泪小管断裂吻合术 溢泪 

分 类 号：R777.2[医药卫生—眼科]