环形硅胶双泪道引流管与硬膜外麻醉导管治疗外伤性泪小管断裂的疗效观察
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Observation of silicone tube double-passage annular lacrimal intubation and epidural catheter for repairing the traumatic lacrimal rupture
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    摘要:

    目的:探讨环形硅胶双泪道引流管与硬膜外麻醉导管治疗外伤性泪小管断裂的疗效和特点。

    方法:回顾分析2009-01/2013-12我科收治的外伤性泪小管断裂患者62例62眼,其中环形硅胶双泪道引流管组32例32眼,硬膜外麻醉导管组30例30眼。所有患者均在显微镜下寻找到断端并顺利实施吻合手术。对两种手术方式的手术时间、术后反应、术后效果及并发症等情况进行回顾性分析。

    结果:环形硅胶双泪道引流管组的手术时间为55~120(平均85.17±15.05)min,硬膜外麻醉导管组的手术时间为30~70(平均49.83±10.71)min。环形硅胶双泪道引流管组术后1wk吻合口红肿4例(12.5%),硬膜外麻醉导管组术后1wk吻合口红肿24例(80%)。拔管后1wk冲洗泪道,环形硅胶双泪道引流管组有效31例(97%),硬膜外麻醉导管组有效26例(87%)。环形硅胶双泪道引流管组术后6mo眼睑外翻2例(6%),泪小点撕裂1例(3%)。硬膜外麻醉导管组术后6mo眼睑外翻10例(33%),泪小点撕裂5例(17%)。

    结论:环形硅胶双泪道引流管与硬膜外麻醉导管均可用于治疗外伤性泪小管断裂,均可获得良好的效果,环形硅胶双泪道引流管术后反应轻,术后并发症少,但手术时间长,硬膜外麻醉导管手术时间短,但术后反应重,并发症多。

    Abstract:

    AIM:To evaluate the efficacy and characteristics of silicone tube double-passage annular lacrimal intubation and epidural catheter for repairing the traumatic lacrimal rupture.

    METHODS:Retrospective case study. Sixty-two cases(62 eyes)with traumatic lacrimal rupture were involved in the study from January 2009 to December 2013. Thirty-two cases(32 eyes)were treated with silicone tube double-passage annular lacrimal intubation, 30 cases(30 eyes)with epidural catheter. All cases were underwent anastomosis surgery successfully after having searched for the broken ends of canaliculus by operation microscope. The operation time, postoperative reaction, efficacy, complications and so on were retrospectively analyzed between two methods.

    RESULTS:The operation time of silicone tube double-passage annular lacrimal intubation group was 55~120(85.17±15.05)min and epidural catheter group was 30~70(49.83±10.71)min. Four cases(12.5%)in silicone tube double-passage annular lacrimal intubation group happened postoperative anastomotic inflammation in 1wk and 24 cases(80%)happened in epidural catheter group. Thirty-one cases(97%)in silicone tube double-passage annular lacrimal intubation group and 26 case(87%)in epidural catheter group were anastomosed successfully 1wk after the stents was removed. At 6mo after surgeries, in silicone tube double-passage annular lacrimal intubation group, 2 cases(6%)were accompanied by lower eyelid ectropion and 1 case(3%)were accompanied by lacrimal puncta laceration. And in epidural catheter group, 10 cases(33%)were accompanied by lower eyelid ectropion and 5 case(17%)were accompanied by lacrimal puncta laceration.

    CONCLUSION:A good result can be obtained by using the silicone tube double-passage annular lacrimal intubation and epidural catheter for repairing the traumatic lacrimal rupture. But in silicone tube double-passage annular lacrimal intubation group, postoperative reaction is lighter and complications can be less. In epidural catheter group, postoperative reaction is heavy and complications are more.

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朱江,黄振平.环形硅胶双泪道引流管与硬膜外麻醉导管治疗外伤性泪小管断裂的疗效观察.国际眼科杂志, 2016,16(1):163-165.

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  • 收稿日期:2015-09-28
  • 最后修改日期:2015-12-12
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  • 在线发布日期: 2015-12-28
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