陈旧性下泪小管断裂吻合手术中内眦韧带定位的意义  

The significance of localization of medial canthal ligament in the operation of anastomosis for obsolete inferior lacrimal canalicular laceration

作　　者：薛信君[1] 张晓俊[1] 袁鹂[1] 司晓静[1] Xue Xinjun;Zhang Xiaojun;Yuan Li;Si Xiaojing(Department of Ophthalmology,The Second,Affiliated Hospital of Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学第二附属医院眼科,南京210000

出　　处：《中华眼外伤职业眼病杂志》2021年第2期116-120,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价陈旧性下泪小管断裂吻合手术中内眦韧带定位的意义。方法回顾性分析南京医科大学第二附属医院眼科2016年1月至2019年8月陈旧性下泪小管断裂吻合手术19例的临床资料,所有患者采用内眦韧带定位法寻找泪小管鼻侧断端。术后随访6个月,观察其疗效。结果19例中1例未能找到泪小管鼻侧断端,进行泪小管泪囊吻合术,半年拔管后泪道阻塞;18例(94.74%)顺利找到泪小管鼻侧断端,进行泪小管吻合术,术后6个月,拔管后泪道冲洗通畅;除3例有轻度下睑外翻畸形,伴有溢泪主诉,其余15例日常生活无溢泪不适,疗效良好。结论在陈旧性下泪小管断裂吻合术中,内眦韧带定位法有良好的应用价值。Objective To evaluate the significance of localization of medial canthal ligament in the operation of anastomosis for obsolete lacrimal canaliculus laceration.Methods The clinical data of 19 cases with obsolete laceration of inferior lacrimal canalicular with anastomosis from Jan.2016 to Aug.2019 in the Second Affiliated Hospital of Nanjing Medical University were analyzed retrospectively.The nasal end of lacrimal canaliculus was located with medial canthal ligament.The follow-up time was 6 months.The efficacy was observed.Results In 19 cases,1 case failed to find the nasal broken end of lacrimal canaliculus,and then underwent dacryocystorhinostomy.And lacrimal duct was obstructive after half a year's extubation.Eighteen cases(94.74%)were successfully found the broken end of lacrimal canaliculus,and then underwent anastomosis of lacrimal canaliculus.At 6 months after surgery,the lacrimal passage was unobstructed after extubation.Among the 18 cases,3 cases had mild ectropion of the lower eyelid,accompanied by complaints of epiphora.The other 15 cases had no discomfort of epiphora in daily life,and the efficacy was satisfactory.Conclusion In the obsolete inferior lacrimal canalicular anastomosis,the localization of medial canthus ligament has a good application value.

关 键 词：断裂 下泪小管 陈旧性 吻合术 定位 内眦韧带 

分 类 号：R779.6[医药卫生—眼科]