外伤性泪小管断裂的诊疗进展  

Progress in the diagnosis and treatment of traumatic lacrimal cacaliculus rupture

作　　者：肖凡 姜艳华 XIAO Fan;JIANG Yanhua(Department of Opthalmology,the Fourth People′s Hospital of Shenyang,Liaoning Province,Shenyang110031,China)

机构地区：[1]沈阳市第四人民医院眼科,辽宁沈阳110031

出　　处：《中国当代医药》2022年第1期23-26,32,共5页China Modern Medicine

基　　金：辽宁省自然基金资助计划项目(2020-MS-330)。

摘　　要：泪小管断裂是临床中眼科急诊常见的外伤之一,通常病情复杂,需要及时手术。若治疗不及时或不当,不但会引起永久性溢泪,还会导致上下睑及内眦部畸形影响患者面部外观,甚至影响患者的身心健康。泪小管的结构细长,泪小管邻近内眦部组织解剖结构精细、手术操作空间狭小、对手术器械及术者技术水平要求高,手术修复难度大。规范泪小管断裂患者的接诊流程,及时有效地复位泪道的解剖结构、选择恰当的人工泪管、恢复泪道的引流功能是眼科医师治疗的最终目标。手术成功率可能受到很多因素的影响,如外伤的程度、外伤后接受治疗的时间、手术具体方式以及人工泪管的材料等。通过查阅近几年文献,本文对泪小管断裂受伤原因、诊断、手术时间、断端的寻找方法、不同人工泪管的选择、人工泪管置入的方法、拔取人工泪管时间以及常见并发症等几个方面做一简要综述。Lacrimal canaliculus rupture is one of the commom injuries in clinical ophthalmology.It is usually complicated and requires timely surgical anastomosis.If it is not timely or improper,it will not only lead to permanent lacrimal overflow,but also cause eyelid deformity,which affects the appearance and physical and mental health of patients.The structure of lactear canaliculus is slender,the anatomical structure of tissue adjacent to inner canthus is fine,the operation space is narrow,and the technical level of surgical instruments and surgeons is high,so the surgical repair is difficult.The final goal of ophthalmologist′s treatment is to standardize the treatment process of patients with lacrimal canaliculus fracture,timely and effectively reset the anatomical structure of lacrimal duct,select appropriate artificial lacrimal duct and restore the drainage function of lacrimal duct.The success rate can be influenced by a number of factors,including the degree of trauma,the length of post-traumatic treatment,the type of surgery,and the material of the stent.Reviewing recent literature,the diagnosis and treatment of lacrimal canaliculus rupture has attracted much attention and made great progress.In this paper,the etiology,diagnosis,timing of treatment,location of the broken end,support selection,catheterization method,extubation time and prognosis of lacrimal canaliculus rupture are briefly reviewed.

关 键 词：泪小管断裂 泪小点 内眦畸形 人工泪管 溢泪 

分 类 号：R779.6[医药卫生—眼科]