泪小管断裂吻合术方法的改良及规范化临床研究  

Clinical study on the improvements and standardizes of anastomosis method treating the laceration of lacrimal ductule

作　　者：杨代慧[1] 娄斌[1] 顾行慧[1] 

机构地区：[1]南京医科大学第二附属医院眼科,210011

出　　处：《临床眼科杂志》2011年第4期349-351,共3页Journal of Clinical Ophthalmology

基　　金：江苏省高校自然科学基金资助项目(08KJD320003)

摘　　要：目的探讨泪小管断裂吻合术方法的改良、临床疗效及其规范化方案。方法回顾性系列病例研究。2007年9月至2010年8月南京医科大学第二附属医院眼科对122例(122只眼)外伤性泪小管断裂患者,在显微镜下直视法应用探通导引针,置入硅胶管治疗,留管3～6个月,拔管后随访6个月,观察疗效。结果 122只眼均顺利拔管,其中71.31%(87/122)治愈,即无流泪,泪道冲洗通畅,泪道内镜下见泪道管腔清晰;18.85%(23/122)好转,即轻微流泪,泪道冲洗通,但不畅,泪道内镜下见泪道管腔少许瘢痕增生和管道狭窄;9.84%(12/122)无效,即仍流泪,泪道冲洗不通,泪道内镜下见管腔瘢痕阻塞。该手术治疗总有效率为90.16%(110/122)。结论应用改良式吻合手术方法的规范化方案诊治外伤性泪小管断裂可大大提高临床疗效,且微创和操作简便,该方法值得推广应用。Objective To investigate the improvements,the clinical curative effects and the standardization of diagnosis and treatment program of anastomosis method treating the laceration of lacrimal ductule.Methods In this retrospective cases series,122 patients（122 eyes） with the laceration of lacrimal ductule between Sep.2007 to Aug.2010 from the Second Affiliated Hospital of Nanjing Medical University were treated by using guided needle probing and implanting silicone tubes under the microscope.All the patients were tubed 3 to 6 months and were followed up after operation for 6 months.Results All the 122 eyes were successfully taken out of tubes.As follow-up,the overall successful rate was 71.31%（87/122）,which were absent lacrimation,were smooth in irrigation of lacrimal passage and were clear in lacrimal duct lumen under endoscope of lacrimal drainage system.Tweenty-three eyes（18.85%） relief from symptoms,which were light lacrimation,were unobstructed in irrigation of lacrimal passage and had little scar and narrow pipe in lacrimal duct lumen under endoscope of lacrimal drainage system.Twelve eyes（9.84%） were ineffective,which were lacrimation,were obstructed in irrigation of lacrimal passage and were scar obstructed in lacrimal duct under endoscope of lacrimal drainage system.The effective rate of treatment was 90.16%.Conclusion Application of improved standardization of the program consistent with diagnosis and treatment of surgical traumatic canalicular laceration can greatly improve the clinical efficacy,and minimally invasive,simple,the method should be widely applied.

关 键 词：泪小管断裂 吻合术 规范化方案 

分 类 号：R779.6[医药卫生—眼科]