双泪小管置管法修复泪小管断裂的临床应用  

Clinical application of the double-canalicular technique repairing the canalicular laceration

作　　者：晓琴[1] 白玉玲[1] 田世元[1] 

机构地区：[1]内蒙古民族大学附属医院眼科,内蒙古通辽028000

出　　处：《中华眼外伤职业眼病杂志》2012年第10期777-779,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨应用硬膜外导管行双泪小管置管法修复泪小管断裂手术的安全性和有效性。方法回顾性分析42例（42眼）采用硬膜外导管行双泪小管置管法修复泪小管断裂的病例资料，下泪小管断裂38例，上下泪小管断裂4例。手术均在手术显微镜下进行，用硬膜外导管（直径0．6—0．8mm）作为泪管支架，从下泪点穿人从颞侧断裂口穿出，再从鼻侧断裂口穿入，经泪总管至鼻泪管。用8—0丝线吻合泪小管两断端2针，结节缝合结膜，肌层和皮肤。将硬膜外导管外露端反插入上泪点至泪囊。结果42例中，治愈36例，基本治愈4例，无效2例。拨除硬膜外导管后，42例随访2～6个月。所有病例术后眼睑伤口愈合良好，泪点位置正且无裂伤，无眼睑或内眦外伤性畸形。结论双泪小管置管法修复泪小管断裂，对泪道损伤小且支撑管隐蔽不影响患者外观，同时还克服了冬季导管外露的弊端。在上下泪小管断裂伤病例，可用一根支撑管吻合上下泪小管。Objective To evaluate the efficacy and safety of the double-canalicular technique for repairing the canalieular laceration by the epidural guiding tube. Methods Retrospective analysis of 42 ca-ses （42eyes）, which underwent canalicular laceration repaire by double-canalicular technique, with epidural guiding tube to repair inferior canalicular laceration in 38 patients, superior laceration in 4 patients. All the operations were performed under surgical microscope and epidural guiding tube （ the diameter is 0.6 - 0.8 mm） was used as the bracket of canaliculus. The tube was inserted into the inferior punctum and threaded from the temporal breakage, and then went into the breach of nasal side, which went through the lacrimal sac into nasolacrimal canal. Conjunctiva, muscular layer and skin were sutured by tying knots. Epidural guiding tube exposed and were unti-inserted from the punctum to the dacryocyst. Results Among 42 patients, 36 patients were cured entirely, and 4 patients were meliorated. After the outer catheter was extracted, 42 pa- tients complied with scheduled follow up 2 - 6 months. All the patients had got good recovery of eyelid lacer- ation with no traumatic deformity in eyelid and eanthus. Conclusions Double-eanalieular technique for re- pairing the canalicular laceration had little harm on the lacrimal passage and overcame the drawbacks of the exposure of the catheter. One tube could be used for anastomosis in the cases of the superior and inferior punctum breakages.

关 键 词：泪小管断裂 修复 双泪小管置管法 

分 类 号：R779.6[医药卫生—眼科]