双路法与环形法插管在泪小管吻合术中的应用比较  

The comparison of double-passage and circle-passage in the treatment of canalicular laceration

作　　者：陶爱平[1] 刘正明[1] 赵艳[1] 秦毅[2] 

机构地区：[1]安徽省中医院眼科,合肥230031 [2]首都医科大学附属北京同仁医院眼科中心

出　　处：《临床眼科杂志》2009年第5期454-456,共3页Journal of Clinical Ophthalmology

摘　　要：目的比较双路法和环形法两种不同泪道插管方法在一期泪小管断裂吻合手术中的应用。方法47例(47只眼)在伤后48h内行吻合手术的外伤性泪小管断裂患者,23例双路插管法,24例环形插管法,均采用外径10mm的硅胶管留置于泪道内12周,对比双路法和环形插管法的异同。比较两种方法插管操作的耗时、术后不适症状和拔管后12周时的通畅情况。结果双路插管法操作耗时(14.4±3.0)min,环形插管法操作耗时(15.5±1.4)min,t=1.060,P=0.302;两组术后均有少数患者有不适症状,经过恰当的处理后,均坚持到12周拔管;拔管后12周的通畅率,双路法20/23(86.96%),20/24(83.33%),χ2=0.122,P=0.727。结论采用环形或双路插管均效果较好;手术耗时相近,但操作难易的环节不同;双路法引起的不适症状较多,环形法引起的不适症状较重,但均可控制。Objective To compare the effectiveness of double-passage and circle-passage eanalicular intubation techniques applied in the treatment of patients with trauma of inferior canalicular laceration. Methods 47 patients （47 eyes ） underwent the surgery of reconstruction of lacrimal system within 48hr after inferior canalieular laceration by use of sillcon stents. All patients divided into 2 groups, 23 cases （ group I ） by double-passage canalicular intubatian, 24 eases （ group II ） by ciwle-passage. All stents had been retained for 12 weeks, and all patients had been followed up at weekly intervals for four months. We evaluated the two techniques according to the operation time of intubating, postoperative complications and the function of lacrimal drainage system. Results Operation time of double-passage intubating was 14.4 ± 3. 0min, circle- passage 15.5± 1.4min, t = 1. 060, P =0.302. The majority of patients did not experience any untoward symptoms from these silicon stents. For some patients with complications, which we solved by adjusting the silicon stentts and using medicine drops. The function of lacrimal drainage system was examined by irrigation. The success rate was 20/23 （86.96%） in group I, and 20/24 （ 83.33% ） in group II, χ^2 = 0. 122, P = 0. 727. Conclusions Both techniques for inferior canalieular laceration were simple, and have good prognosis. Double-passage can cause more complications than circle-passage, while circle- passage can cause worse complications than double-passage. Operators could choose one of techniques according to their fancy and hobby.

关 键 词：下泪小管断裂 泪道插管 双路法 环形法 

分 类 号：R779.6[医药卫生—眼科]