泪小管断裂显微吻合术中支架的改良

目的 探讨外伤性泪小管断裂吻合术中支架放置的新方法，提高泪小管吻合术的成功率。方法 在手术显微镜下，利用硬膜外麻醉导管行30例泪小管断裂吻合术，其中改良组15例将导管从泪小点穿出皮肤固定的做法改为将导管潜行放置并固定于泪小管内，3个月后从鼻腔拔除支架。结果 改良组中14例吻合成功，由于导管不从泪小点穿出，术中和术后未发生泪小点损伤等并发症。对照组则有8例出现吻合口阻塞、泪小点损伤等并发症。结论 应用显微外科技术进行改良的潜行支架放置法，可进一步提高泪小管吻合术的成功率。

Improvement of upholder placement in microanastomosis of lacrimal canal(microcanaliculoplasty)

Objective To explore the improvement of upholder placement in the anastomosis of traumatic canalicular laceration and increase the rate of success of canaliculoanastomosis Methods Thirty cases with traumatic canalicular laceration were treated by microcanaliculoplasty (microanastomosis) using the upholder of an epidural conduct 15 cases had been operated by a new improved method which the upholder of an epidural conduct was not fixed out of skin through the lacrimal punctum but was placed and fixed in the lacrimal canal The upholder would be pulled out from the nasal cavity after three months later Results Among the 15 cases which were operated by the improved method of upholder placement,14 cases were very successful There was no complication of injury on lacrimap punctum because the upholder of conduct was not passed through the lacrimal point In the group of control experiment,the complications of anastomotic blockage and injury on lacrimal punctum had been occurred in 8 cases Conclusion The rate of success of canaliculoanastomosis could be increased by using microscope and improving the upholder replacement [Key words] Canalicular laceration; Microcanaliculoplasty; Upholder; Microsurgical operation