劈管法硅胶泪道管环行固定术治疗泪小管断裂  

Spitting-tube method and silicone tube circular canalicular intubations for repairing lacerations of canaliculus

作　　者：卢建民[1,2] 施玉英[3] 

机构地区：[1]中国康复研究中心北京博爱医院眼科 [2]首都医科大学康复医学院,100068 [3]首都医科大学附属北京同仁医院北京同仁眼科中心

出　　处：《眼科》2011年第5期311-314,共4页Ophthalmology in China

摘　　要：目的探讨劈管法硅胶泪道管环行固定在泪小管断裂吻合术中的应用价值。设计回顾性病例系列。研究对象一期下泪小管断裂患者47例。方法全部患者用猪尾钩自上泪小管向下泪小管做环形插管,劈管法植入硅胶管,并在硅胶管内穿入缝线形成环形管做泪道内支撑物固定。观察12~24个月,观察疗效：无溢泪、冲洗通畅为治愈;有溢泪,但冲洗通畅或冲洗通而不畅为好转;冲洗泪道不通为无效。眼部刺激症状依程度轻重评为0~5分。主要指标泪道通畅程度,泪小点或泪小管损伤情况,眼部刺激症状评分,意外脱管情况。结果术后12个月,治愈43例（91.5%）,好转4例（8.5%）。无下泪小点及近端撕裂,眼部刺激症状评分平均1.5分,无意外脱管情况。结论硅胶泪道管采用劈管法环行固定术治疗泪小管断裂具有治愈率高、刺激性小、并发症少等优点。Objective To evaluate the value of silicone intubation with splitting-tube and ring-fixed method in repairing the inferior canalicular laceration.Design Retrospective case series.Participants 47 primary operated patients with inferior canalicular laceration.Methods All cases（47 cases） were used a twisted pigtail probing through the canaliculus from superior to inferior.Silicone tube with splitting-tube method was intubated and passed over the suture to create a circlage,which was fixed within superior and inferior lacrimal canaliculus.Patients were followed up for 12~24 months.Therapeutic effect evaluation standards were as follows： unobstructed on irrigation and no epiphora was defined as successful;unobstructed on irrigation but some times epiphora was defined as improved;obstruction was defined as failed.Ophthalmic irritation was evaluated using a 0 to 5 scoring scale.Main Outcome Measures Canalicular patency degree,damage of the lacrimal point and near canaliculus,ocular irritation score,and incidence of silicon tube falling out.Results 12 months after surgery,operation was successful in 91.5%（43/47 cases） of eyes.Clinical improvement was achieved in 8.5%（4/47 cases） of eyes.No unexpected tube falling out or iatrogenic damage to the lacrimal point and near canaliculus was found.Conclusions Silicone tube intubation with splitting-tube method and ring-fixed in the prosthesis of inferior canalicular laceration is an ideal method for treatment of canaliculus laceration,which is effective,low irritation and good cosmetic.

关 键 词：泪小管断裂/外科学 泪小管吻合术 硅胶管 

分 类 号：R779.6[医药卫生—眼科]