自制硬膜外麻醉导管在泪小管断裂治疗中的临床应用  

Clinical application of self-made epidural anesthetic catheter in the treatment of canalicular laceration

作　　者：郑春荣 孙廷励[1] ZHENG Chunrong;SUN Tingli(Liuzhou People′s Hospital,Liuzhou 545006,Guangxi,China)

机构地区：[1]柳州市人民医院,广西柳州市545006

出　　处：《微创医学》2020年第4期443-445,共3页Journal of Minimally Invasive Medicine

摘　　要：目的观察在自制硬膜外麻醉导管引导下治疗泪小管断裂的临床效果。方法选择40例泪小管断裂患者,均在显微镜下寻找到鼻侧泪小管断端,并在自制的硬膜外麻醉导管引导下,快速、顺利地置入硬膜外麻醉导管作为支撑物。术后进行消炎、消肿、预防感染,注意观察患者有无睑外翻、泪小点豁裂或外翻及溢泪等情况,评估手术效果。结果 36例患者在拔除支撑物后未出现溢泪,总治愈率为90.0%(36/40)。2例下泪小管断裂伴下睑严重裂伤患者术后出现下睑、泪小点外翻;1例患者术后3 d出现下泪小点豁裂;1例下泪小管断裂合并严重鼻骨骨折患者,因支撑物未能完全植入鼻泪管处,2周后支撑物脱出。上述4例患者后期均出现了溢泪。结论在自制的硬膜外麻醉导管引导下,可快速、顺利地将支撑物插入鼻泪管。硬膜外麻醉导管来源方便、价格便宜。将其作为泪道支撑物,既提高了手术效率,又减轻了患者的经济负担,在贫困地区和基层医院不失为一种可行的方法。Objective To observe the clinical effects of self-made epidural anesthetic catheter in the treatment of canalicular laceration.Methods A total of 40 patients with canalicular laceration were selected,searching the broken end of the lacrimal ductule at the nasal side through a microscope,and quickly and successfully inserting epidural anesthetic catheter as the holder guided by the self-made epidural anesthetic catheter.After operation,the patients were treated with anti-inflammation,anti-swelling and prevention of infection.The patients were observed for the presence of ectropion,crack or ectropion of lacrimal punctum,and epiphora,etc.,and the operative results were evaluated.Results A total of 36 patients had no epiphora after the holder remove.The total cure rate was 90%(36/40).Two patients with lower canalicular laceration complicated with a severe laceration of lower eyelid had ectropion of lower eyelid and lacrimal punctum after operation;1 patient had the crack of lacrimal punctum 3 days after operation,and 1 patient with canalicular laceration and severe fracture of the nasal bone,because the holder was not completely implanted into the canalis nasolacrimal,the holder prolapse occurred after 2 weeks.The 4 patients mentioned above all had epiphora in the latter stage.Conclusion Guided by the self-made epidural anesthetic catheter,the holder can be inserted to the canalis nasolacrimal quickly and successfully.The epidural anesthetic catheter is convenient and cheap.As the holder of lacrimal passage,it not only improves the efficiency of operation,but also reduces the financial burden of patients.It is a feasible method in poor areas and basic hospitals.

关 键 词：泪小管断裂 硬膜外麻醉导管 治疗 

分 类 号：R777.2[医药卫生—眼科]