改良的硬膜外麻醉管双泪小管置管法治疗泪小管断裂的临床疗效观察  

Efficacy of modified epidural anesthesia catheter bicanalicular intubation on canalicular laceration

作　　者：张海涛 刘光明 李淑婷 Zhang Haitao;Liu Guangming;Li Shuting(Department of Ophthalmology,the Third Affiliated Hospital of Soochow University,Changzhou 213000,China)

机构地区：[1]苏州大学附属第三医院眼科

出　　处：《临床眼科杂志》2020年第1期77-79,共3页Journal of Clinical Ophthalmology

基　　金：江苏省自然科学基金青年项目(BK20190162)

摘　　要：目的观察改良的硬膜外麻醉管双泪小管置管法治疗泪小管断裂的临床疗效。方法选取2014年1月至2018年10月苏州大学附属第三医院收治的42例(42只眼)泪小管断裂患者。显微镜下寻找患者的泪小管鼻侧断端,取14 cm长度的硬膜外麻醉管,一端为盲端,另一端为开口端,用酒精灯加热开口端使之形成盲端。扩张上下泪小点后,在探针引导下将硬膜外麻醉管两盲端自上下泪小管插入至鼻泪道,行泪小管吻合后缝合眼睑皮肤裂伤。术后3个月拆除泪道置管。观察术后第6个月患者泪道冲洗通畅情况及并发症。结果2例患者术后1月脱管;泪小点撕裂者2例。术后第6个月,泪道冲洗通畅者38例,通而不畅者2例,不通者2例。结论改良的硬膜外麻醉管双泪小管置管法治疗泪小管断裂安全有效,手术操作及术后护理简便,有效率高,花费少,外观影响小,患者满意度高。Objective To investigate the clinical effect of modified epidural anesthesia catheter bicanalicular intubation on canalicular laceration.Methods A total of 42 patients(42 eyes)with canalicular laceration in the Third Affiliated Hospital of Soochow University from January 2014 to October 2018 were recruited.Under operating microscope,42 patients received the lacrimal canaliculus anastomosis combined with modified epidural anesthesia catheter bicanalicular intubation,and the clinical outcome were analyzed.The tube was removed at 3 months after the surgery.Lacrimal duct patency and complications were assessed at 6 months after the surgery.Results Two patients removed the lacrimal canaliculus anastomosis himself at 1 month after the surgery.Lacrimal puncta laceration occurred in 2 patients.At the last follow-up,38 patients were cured,lacrimal duct narrow was noted in 2 patients and lacrimal duct obstruction in 2 patients.Conclusions Epidural anesthesia catheter bicanalicular intubation for canalicular laceration is safe with high success rate,high patient satisfaction,low cost,minimal impact on appearance.The surgical operation and post-surgical care is relatively easy.

关 键 词：泪小管断裂 泪小管吻合 改良的硬膜外麻醉管 双泪小管置管 

分 类 号：R779.6[医药卫生—眼科]