特殊双路置管治疗难找断端的下泪小管断裂并鼻泪管阻塞  

Annular bicanalicular intubation of inferior canalicular lacerations with difficult to locate na- sal ends and nasolacrimal duct obstruction

作　　者：田艳明 许正华 乔磊 闫希冬 郭宁 李鹏 薛峥 

机构地区：[1]解放军第四七四医院全军眼科中心,新疆乌鲁木齐830012

出　　处：《中国实用眼科杂志》2012年第2期179-181,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 介绍一种难找断端的下泪小管断裂合并鼻泪管阻塞的手术方法.方法 回顾2007～2010年泪小管断裂合并鼻泪管阻塞患者12例,女2例,男10例,平均年龄41岁,使用记忆合金丝探针,通过自上下泪点向鼻腔留置双引线,然后以引线引导引线型硅管的手术方法实现双路置管,术后平均4月拔管,拔管后随访3～6月.记录手术时间,观察术后并发症及拔管后泪道通畅情况.结果 该方法成功实现双路置管及吻合下泪小管,手术时间最短40 min,最长1 h 20 min,平均55 min.2例术后1周上泪小点撕裂（未处理）,1裂术后5d下泪点撕裂给予局部显微缝合.10例拔管后,溢泪消失,随访期内泪道冲洗通畅,1例通而不畅,溢泪症状缓解,1例冲洗不通伴溢泪.结论 结合特殊器械猪尾探针可以实现难以寻找断端的下泪小管断裂合并鼻泪管阻塞双路快速吻合,不影响外观,而且留管时间长,并发症少,方法简便实用.Objective To introduce a surgical approach for treatment of difficult to locate nasal ends accompanied with nasolacrimal duct obstruction. Methods A retrospective,non-comparative case series with clinical interviews was conducted for an average of 6 months of follow-up visits of symptomatic patients.Twelve patients were included from 2007 to 2010.The canaliculi and their eyelids were repaired using annular bicanalicular intubation.The patients experienced relief in the frequency of epiphora and discharge was observed. Results Lower canalicular lacration of all patients was successfully repaired using annular bicanalicular intubation.The mean operation time was about 55 minutes.The silicone tube was placed for a mean of 4 months （ranged 3～6months）,and the mean postoperative follow-up was 6 months （ranged 3～6 months）.Epiphora disappeared in 10 cases,epiphora subjectively improved in 1, 1 patient epiphora persisted but without further treatment.Conclusions The introduced procedure is an efficient solution for repairing inferior canalicular lacerations when the nasal ends are difficult to locate and combined with nasolacrimal duct obstruction.

关 键 词：泪小管断裂 鼻泪管阻塞 硅管 双路插管 

分 类 号：R777.22[医药卫生—眼科]