双步泪道逆行置管术治疗外伤性下泪小管断裂  

Bi-step retrograde intubation procedure in the treatment of traumatic inferior canalicular laceration

作　　者：周祁[1] 吴名峰[1] 杜飞[1] 孙小婷[1] 王震[1] 李厚硕[1] 毕燕龙[1] 

机构地区：[1]同济大学附属同济医院眼科,上海200065

出　　处：《中华眼外伤职业眼病杂志》2012年第12期926-928,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨双步泪道逆行置管治疗下泪小管断裂的临床疗效。方法对58例（58眼）外伤性下泪小管断裂分为两组：A组28例为双步置管组：先于急诊裂隙灯显微镜下直接以泪道探通引导针从鼻侧断端插入，然后逆行置入带泪小管侧管的泪道引流管。再于手术显微镜下进行断裂泪小管的吻合。B组30例为单步置管组：即等待手术室安排后，直接在手术显微镜下完成上述操作。结果所有患眼均在术中找到下泪小管断裂的鼻侧断端，A组寻找耗时（7．5±4．3）min；B组寻找耗时（24．4±13．5）min（P〈0．01）。术后3个月拔管，之后随访（14．2±3．7）个月，A组治愈26例（92．86％），拔管后1周再阻塞1例（3．57％）；B组治愈26例（86．7％），拔管后1周再阻塞2例（6．67％）。结论双步泪道逆行置管治疗下泪小管断裂手术较快、损伤小、痛苦小。Objective To investigate the clinical effects of bi-step retrograde intubation procedure in the treatment of traumatic inferior canalicular laceration. Methods Fifty-eight consecutive traumatic in- terior canalicular laceration cases （58 eyes） were randomly separated into two groups. Group A contenting 28 cases was bi-step group： initially the medial cut end of the lacerated canaliculus was located under slit- lamp microscope in the out -patient department, and followed by a probing through the cut end into the na- sal lacrimal duct, then the patient take a supine position and a drainage silicon tube with a lateral canalicular tube was retrograded placed. The canalicular anastomosis of the separated cut ends was performed under the surgical microscope in the operating room. Group B contenting 30 cases was single-step group：all the surgi- cal procedures were performed in the operating room after several hours queuing waiting for the arrangement. Results The medial cut ends of the lacerated canaliculus were located in all the cases, but （ 7.5 ± 4.3 ） min was needed in group A and （24.4 ± 13.5 ） min were needed in group B （ P 〈 0. O1 ）. The retrograded placed tubes were pulled out 3 months later, and whereafter with a （ 14.2 ± 3.7 ） months follow up period. Twenty-six cases （92.86%） were cured and 1 case （3.57%） was re-obstructed 1 week after tube removing in group A; Twenty-six cases （86.7%） were cured and 2 cases （6.67%）was re-obstructed 1 week after tube removing in group B. Conclusions Bi-stepretrograde intubation procedure in the treatment of traumatic inferior canalicular laceration has properties of quick, less tissue injury and light paining.

关 键 词：泪小管断裂 吻合术 泪道置管 

分 类 号：R779.6[医药卫生—眼科]