自制套环泪道硅胶支撑管在泪小管断裂修复手术中的应用  

Application of self-made annular lacrimal silicone stent intubation in the anastomosis surgery of canalicular laceration

作　　者：韩军军 陈红玲 张贤亮 王甜 刘瑞星 庆惠玲 Han Junjun;Chen Hongling;Zhang Xianliang;Wang Tian;Liu Ruixing;Qing Huiling(Department of Ophthalmology,Henan Provincial People’s Hospotal,Henan Eye Hospital,Henan Eye Institute,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院眼科、河南省立眼科医院、河南省眼科研究所,郑州450003

出　　处：《中华眼外伤职业眼病杂志》2023年第3期202-205,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：国家自然科学基金(青年科学基金项目)(82101090);河南省医学科技攻关计划项目(SBGJ202102050)。

摘　　要：目的观察自制套环泪道硅胶支撑管在泪小管断裂修复手术中的应用效果。方法回顾性病例系列研究。收集河南省人民医院眼科自2018年1月至2020年12月应用自制套环泪道硅胶支撑管行泪小管断裂修复术的泪小管断裂患者267例(267眼)临床资料。随访6~12个月,观察并分析术中及术后并发症,末次随访解剖成功率和功能成功率。结果所有患者均顺利完成自制套环泪道硅胶支撑管的置入,手术成功率为100.00%。术后解剖成功256例(95.88%,256/267),功能成功239例(89.51%,239/267)。术中2例(0.74%,2/267)从鼻腔用缝线牵引泪道硅胶支撑管时出现线结处硅胶管断裂,重新制作硅胶支撑管后手术均顺利完成。术后5例(1.87%,5/267)发生眼睑外翻,泪道冲洗通畅,并于术后6个月行睑外翻矫正术,术后恢复良好,溢泪症状消失;术后6例(2.25%,6/267)泪道硅胶支撑管脱出,及时予以还纳;1例(0.37%,1/267)泪道硅胶支撑管丢失,术后随访泪道冲洗通畅,无溢泪症状。术后拆除泪道硅胶支撑管的时间为(3.20±0.97)个月。结论泪小管断裂修复术中应用自制套环泪道硅胶支撑管手术成功率较高,并发症少,安全有效。Objective To observe the clinical safety and efficacy of self-made annular lacrimal silicone stent intubation for the treatment of canalicular laceration.Methods This was a retrospective case series study.A total of 267 eyes of 267 cases with traumatic canalicular laceration from Jan.2018 to Dec.2020 in Henan Eye Hospital were involved.All cases were treated with self-made annular lacrimal silicone stent intubation and followed up for 6-12 months.The intraoperative and postoperative complications,the anatomy success rate and functional success rate at the last follow-up were observed and analyzed.Results All cases(100.00%)were successfully implanted with the self-made annular lacrimal silicone stent intubation.Anatomical success was achieved in 256 cases(95.88%,256/267)and functional success was observed in 239 cases(89.51%,239/267)using the self-made annular lacrimal silicone stent intubation.Two cases(0.74%,2/267)were accompanied by the rupture of silicone stent tube at suture knot during the traction of the tube from nasal cavity,and the operation was successfully completed after the silicone stent tube was reprepared.Five cases(1.87%,5/267)were accompanied by postoperative eyelid ectropion,which recovered after ectropion correction surgery at 6 months postoperatively.Six cases(2.25%,6/267)and 1 case(0.37%,1/267)of slippage and losing of silicone stent tube occurred at the last follow-up,respectively.The silicone stent tubes were remained for(3.20±0.97)months postoperatively and then removed.Conclusion The application of the self-made annular lacrimal silicone stent intubation,which has a high successful rate and less complications,is safe and effective to treat canalicular laceration.

关 键 词：泪小管断裂 支撑管 吻合手术 硅胶 

分 类 号：R779.6[医药卫生—眼科]