下泪小管断裂鼻侧断端三种寻找方法的比较  

The comparison of three different methods to localize nasal broken end of lacerated inferior lacrimal canaliculus

作　　者：王玮[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院眼科,武汉430030

出　　处：《中华眼外伤职业眼病杂志》2014年第5期362-364,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的 比较3种不同方式寻找下泪小管断裂鼻侧断端的临床效果.方法 对24例新鲜断裂的外伤性下泪小管,依次通过3种方式（注水寻找法、直视寻找法和探针寻找法）寻找鼻侧断端并对效果进行分析.结果 注水寻找法：24眼中7眼可以明确定位断端,成功率仅29.17％;直视寻找法：24眼均可在手术显微镜下直视寻找到下泪小管鼻侧断端,成功率为100％;探针寻找法：12眼通过探针找到泪小管鼻侧断端,成功率为50％,但4眼穿出假道.结论 对于新鲜的外伤性下泪小管断裂者,首选直视寻找法,若寻找时间超过半小时未果的病例,可尝试注水寻找法,探针寻找法是最后的选择,对于组织水肿明显的患者,应尽量避免使用.Objective To compare the clinical efficacy of three different methods to localize nasal broken end of lacerated inferior lacrimal canaliculus. Methods 24 cases of lacerated inferior lacrimal canaliculus due to trauma were treated by three different methods （ pushing water into the superior punctum, finding directly under operating microscope, probing needle）to localize nasal breakage. The clinical effects were analyzed. Results The searching method of pushing water into the superior punctum was performed in 24 cases and only 7 nasal breakages were localized successfully accounting for 29. 17%. The searching method of finding directly under microscope was performed in 24 cases and the nasal breakages were found in all cases and the success rate was 100%. The searching method of probing needle was performed in 24 cases. The nasal broken ends were localized in 12 cases, but 4 cases were not successful because of iatrogenic false passage. The success rate was 50%. Conclusion For the patients with lacerated inferior lacrimal canaliculus due to trauma, searching nasal broken ends directly under microscope is the preferred method. If the searching time is more than 30 minutes, pushing water into the superior punctum can be tried. Using probing needle is the last choice, but not be performed when the trauma tissue is edema.

关 键 词：断裂 泪小管 断端 鼻侧 

分 类 号：R779.6[医药卫生—眼科]