猪尾巴探针引导硅胶管植入术与泪道探针引导逆行置管术在外伤性泪小管吻合术中的应用比较  

Pigtail probe-guided silicone tube insertion versus lacrimal duct probe-guided retrograde tube insertion in the repair oftraumaticallylacerated lacrimal duct

作　　者：曾朝霞[1] 梁艳丽[1] 陈荟郦[1] 苗小晴 

机构地区：[1]湛江中心人民医院眼科,524037

出　　处：《中华眼科医学杂志（电子版）》2015年第5期19-23,共5页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

摘　　要：目的比较猪尾巴探针引导硅胶管植入术与泪道探针引导逆行置管术治疗外伤性泪小管断裂的临床疗效及并发症的发生情况。方法收集2012年5月至2015年4月湛江中心人民医院眼科收治的90例(90只眼)外伤性泪小管断裂患者的临床资料。按照手术方法将患者分为观察组和对照组,每组各45例(45只眼)。观察组患者行猪尾巴探针引导硅胶管植入术进行治疗,对照组患者行泪道探针引导逆行置管术进行治疗。观察组和对照组的临床疗效按照显效、有效和无效分为三组,以例数和百分比的形式表示,并采用Kruskal-Wallis H秩和检验的方法进行组间比较;两组患者并发症的发生情况以例数和百分比的形式表示,并采用卡方检验的方法进行组间比较;两组患者手术寻找鼻侧断端的时间及总手术时间以均数±标准差(x珋±s)的形式表示,并采用独立样本t检验的方法进行组间比较。结果观察组显效者37例(37只眼),占82.22%;有效者5例(5只眼),占11.11%;无效者3例(3只眼),占6.67%。对照组显效者35例(35只眼),占77.78%;有效者6例(6只眼),占13.33%;无效者4例(4只眼),占8.89%,两组患者的临床疗效比较,差异无统计学意义,(Hc=-0.53,P>0.05)。观察组发生并发症13例(13只眼),占59.38%;其中结膜炎10例(10只眼),滴用滴眼液后好转;角膜炎2例(2只眼),拔管后治愈;泪小点撕裂1例(1只眼),因打结过紧引起,将线结拉松后好转。对照组发生并发症10例(10只眼),占43.75%;其中结膜炎8例(8只眼),角膜炎1例(1只眼),眼睑外翻因疤痕收缩1例(1只眼),两组患者并发症的发生情况比较,差异无统计学意义(χ2=0.53,P>0.05)。观察组患者手术平均寻找鼻侧断端时间为(4.12±0.75)min,明显短于对照组的(5.88±2.53)min,两组比较,差异有统计学意义(t=5.99,P<0.05)。观察组患者总手术时间为(54.56±12.43)min,明显短于对照组的(70.32±14.55)min,两组比较,差异有统计学意义(t=2.41Objective To comparativelyevaluate the pigtail probc-guidedsilicone tube implantation and lacrimal duct probe-guided retrograde catheter insertion in the repair of traumatic lacrimal tube rupture. Methods This study enrolled 90 patients （90 eyes） who presented with traumatic canalicularlacerations to the Department ofOphthahnology, Zhanjiang Central Hospitalconseeutively between May,2012 and April, 2015. They were randomized to undergopigtail probe-guidcdanastomosiswith a silicone tube （n = 45 ） andconventional lacrimal duct probe-guidedanastomosis with a retrograde catheter （ n = 45 ） respectively. The time length, outcome（ characterized as significantly effective, moderatelyeffective and ineffective respectively） and complications of the procedureswere recorded and analyzed. Results Pigtail probe-guided anastomosis was significantly effective in 37 （82.22%） cases,moderately effective in 5 （ 11.11% ） cases and ineffective in 3 （ 6.67% ） cases. Lacrimal duct probe- guided retrograde catheter was significantly effective in 35 （77.78%） cases, moderately effective in 6 （ 13.33% ） cases and ineffective in 4 （8.89%） cases. The difference in the effectiveness was notsignificant between the two approaches （Hc = 0.53, P〉0.5 ）.Post-surgery complications occurred in 13 （59.38%） cases in the pigtail probe group and inl0 （43.75%） cases in the lacrimal duet probe group （t= 112.34,P〉112.34）. The average time used to find the lacerated end of the lacrimal duet was 5.88±2.53minin the pigtail probe-based proeedureand was 4.12±0.75 min in the lacrimal duct probe-based procedure （ P〈0.05 ）. The average operation time length was 54.56± 12.43 minin the pigtail probe-based procedure andwas 70.32±14.55minin the lacrimal duet probe-based procedure （P〈 0. 05 ）. Conclusion The pigtail probe-guided silicone tube insertion and lacrimal passage probe- guidedretrograde tube insertion are comparatively issignifieantly less time-eomsuming and would have a duetfracture.

关 键 词：猪尾巴探针 泪道探针 泪小管吻合 硅胶引流管 

分 类 号：R779.6[医药卫生—眼科]