应用RS型鼻泪道再通管置入术治疗泪小管断裂的临床观察  

Clinical observation on RS nasolacrimal duct recanalization in the treatment of lacrimal canalicular laceration

作　　者：张爽 丁亚莉 徐良 张林 Zhang Shuang;Ding Yali;Xu Liang;Zhang Lin(Nanyang Municipal Eye Hospital,Nanyang 473000,China)

机构地区：[1]南阳市眼科医院,南阳473000

出　　处：《中华眼外伤职业眼病杂志》2024年第3期192-196,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察应用RS型鼻泪道再通管置入术治疗泪小管断裂的临床效果。方法回顾性病例对照研究。纳入南阳市眼科医院2019年1月至2023年6月住院的泪小管断裂者234例(234眼)。按不同手术方式分为两组:试验组129例(129眼),应用RS型鼻泪道再通管置入术修复泪小管断裂。对照组105例(105眼),应用泪道环形硅胶管置入术修复泪小管断裂。所有患者术后3个月拔出泪道插管。观察两组患者手术时长,术中、术后并发症的发生率及拔管后的泪道冲洗结果。结果试验组手术时长(33.47±10.69)min,短于对照组的(63.18±12.32)min,差异有统计学意义(t=19.75,P<0.001)。试验组术中无鼻腔出血发生,对照组有25例(23.81%)出现术中鼻腔出血,差异有统计学意义(χ^(2)=34.39,P<0.001)。试验组术后脱管者2例(1.55%),对照组1例(0.95%)。术后泪点撕裂者试验组7例(5.43%),对照组3例(2.86%)。两组相比较,术后脱管率(χ^(2)=0.16,P=0.686)及泪点撕裂发生率(χ^(2)=0.93,P=0.334)差异无统计学意义。术后3个月拔管后行泪道冲洗,试验组治愈者109例(84.50%),有效者17例(13.18%),总有效率97.67%(126/129)。对照组治愈者80例(76.20%),有效者21例(20.00%),总有效率96.19%(101/105)。两组治疗总有效率差异无统计学意义(χ^(2)=0.08,P=0.782)。结论RS型鼻泪道再通管置入术治疗泪小管断裂步骤简单,手术时间短,手术并发症少。Objective To observe the clinical efficacy on RS nasolacrimal duct recanalization in the treatment of lacrimal canalicular laceration.Methods This was a retrospective case-control study.Total of 234 eyes of 234 cases with lacrimal canalicular laceration from Jan.2019 to Jun.2023 in Nanyang Municipal Eye Hospital were included.They were divided into two groups based on different surgical methods:129 cases(129 eyes)received RS nasolacrimal duct recanalization tube catheterization as the trial group,and 105 cases(105 eyes)received ring-shaped silicone tube catheterization as the control group.All cases received tube extubation at 3 months postoperatively.The duration of the operation,incidence of intraoperative and postoperative complications,and results of lacrimal irrigation after tube extubation in the two groups were observed.Results The operation duration of the trial group(33.47±10.69)min was shorter than that of the control group(63.18±12.32)min,and the difference was statistically significant(t=19.75,P<0.001).There was no intraoperative nasal bleeding in the trial group,which was lower than the 23.81%(25 cases)in the control group,and the difference was statistically significant(χ^(2)=34.39,P<0.001).There were 2 cases(1.55%)of postoperative tube detachment in the trial group and 1 case(0.95%)in the control group.There were 7 cases(5.43%)of postoperative lacrimal punctum laceration in the trial group and 3 cases(2.86%)in the control group.There was no significant difference in the rate of tube detachment(χ^(2)=0.16,P=0.686)and the rate of lacrimal punctum laceration(χ^(2)=0.93,P=0.334)between the two groups.Lacrimal canaliculus irrigation and tube extubation were performed at 3 months after operation.In the trial group,109 cases(84.50%)were cured and 17 cases(13.18%)were effective,with an overall effective rate of 97.67%(126/129).In the control group,80 cases(76.20%)were cured and 21 cases(20.00%)were effective,with an overall effective rate of 96.19%(101/105).There was no statistical difference in treat

关 键 词：断裂 小管 泪 置管术 再通 鼻泪道 效果 

分 类 号：R779.6[医药卫生—眼科]