硬膜外导管辅助双路置管术与传统术式在泪小管断裂吻合术中的疗效比较  

Comparison of the efficacy of bicanalicular silicone intubation assisted with epidural catheters and traditional surgery in anastomosis for canalicular laceration

作　　者：徐强 孙秋月 马琳丽 蒋燕玲 XU Qiang;SUN Qiuyue;MA Linli;JIANG Yanling(Department of Ophthalmology,Second People’s Hospital of Lianyungang,Bengbu Medical College,Lianyungang Jiangsu 222006,China)

机构地区：[1]蚌埠医学院附属连云港市第二人民医院眼科中心,江苏连云港222006

出　　处：《眼科学报》2021年第11期888-893,共6页Eye Science

基　　金：蚌埠医学院自然科学类项目(BYKY2019252ZD)。

摘　　要：目的:比较硬膜外导管辅助双路置硅胶管术与传统双路置硅胶管术在泪小管断裂吻合术中的疗效。方法:随机将连云港市第二人民医院52例(52眼)行泪小管断裂吻合术的患者分成两组,使用硬膜外导管辅助双路置硅胶管术为A组(30例);使用传统手术方式(双路置硅胶管术)为B组(22例)。比较两组患者术中置管时间、平均手术时间、鼻腔出血率、术中疼痛评分、一次性吻合成功率的差异。结果:在术中置管时间方面,A组为(11.20±3.80)min,B组为(21.50±12.60)min;在平均手术时间方面,A组为(42.70±5.50)min,B组为(62.20±15.20)min;在术中疼痛评分方面,A组为(3.10±0.80)分,B组为(4.60±1.25)分;在鼻腔出血率方面,A组为3.33%(1/30),B组为18.2%(4/22),以上差异均有统计学意义(均P<0.05);但在一次性吻合成功率方面,A组有效率为93.3%(28/30),B组有效率为86.4%(19/22),差异无统计学意义(P>0.05)。结论:在泪小管断裂吻合术中,应用硬膜外导管辅助双路置硅胶管术较传统双路置硅胶管术,在术中置管时间、手术平均时间、鼻腔出血率、患者疼痛程度等方面具有优势,2种置管一次性成功率的差异无统计学意义,硬膜外导管辅助双路置硅胶术方法安全、可靠、优势明显,值得临床手术推广。Objective:To compare the efficacy of bicanalicular silicone intubation assisted with epidural catheters and traditional bicanalicular silicone intubation in the anastomosis of lacrimal canaliculus rupture.Methods:Fiftytwo patients(52 eyes)were randomly divided into two groups.Patients in group A(30 cases)were treated by bicanalicular silicone intubation assisted with epidural catheters,while patients in group B(22 cases)were treated with conventional operation(bicanalicular silicone intubation).The intubation time,average operation time,nasal bleeding rate,intraoperative pain score and one-time success rate were compared between the 2 groups.Results:Intubation time in group A was(11.20±3.80)min and that in group B was(21.50±12.60)min(P<0.05).The mean operation time of group A was(42.70±5.50)min and that of group B was(62.20±15.20)min(P<0.05).Intraoperative pain score was 3.10±0.80 in group A and 4.60±1.25 in group B(P<0.05).The rate of nasal hemorrhage was 3.33%(1/30)in group A and 18.2%(4/22)in group B(P<0.05).With respect to one-time anastomosis success rate assessment,the effective rate was 93.3%(28/30)in group A,and 86.4%(19/22)in group B(P>0.05).Conclusion:During lacrimal canalicular anastomosis,bicanalicular silicone intubation assisted with epidural catheters is superior to bicanalicular silicone intubation in intubation time,average operation time,nasal bleeding rate and pain degree.There is no significant difference between the two methods in one-time success rate.Bicanalicular silicone intubation assisted with epidural catheters is safe,reliable,and worthy of promotion.

关 键 词：硬膜外导管 辅助 双路置管 术中疗效 泪小管断裂 

分 类 号：R779.6[医药卫生—眼科]