上下泪小管断裂鼻侧断端的寻找方法及疗效观察

目的：观察上下泪小管断裂鼻侧断端的寻找方法及手术治疗效果.方法：随机选取28例（28只眼）上下泪小管同时断裂的患者采用显微手术方法,在断端处置水,患者捏鼻用力憋气,鼻侧上、下断端有气泡冒出,寻找到泪小管断端处,以软性医用硅胶管作为泪道支撑,经由6号猪尾巴探针导入,即时吻合上下泪小管,硅胶管留置3个月.结果：28例28只眼都顺利寻找到断端并吻合,术后3个月取出留置硅胶管,24例无溢泪,泪道冲洗通畅,占85.71%;4例轻度溢泪,泪道冲洗通,占14.29%.结论：在显微手术下,患者捏鼻用力憋气,鼻侧断端有气泡冒出,寻找到泪小管断端,以软性医用硅胶管作为泪道支撑,即时吻合上下泪小管,操作简捷,效果良好.

Clinical observation and method of exploring nasal ends of both upper and lower lacerated lacrimal canaliculi anastomosis

Objective To investigate the method of jocating the nasal ends of lacerated canaliculi during anastomosis surgery for upper and lower lacrimal canalicular laxeration patients and its clinical effect, Metheds 28 eyes of 28cases with both upper and lower lacrimal canaliculi laceration in this study. During surgery patients were asked to pinch their noses and hold breath. Water were dropped on the laceratrd canaliculi under the microscope and then the nasal ends of lacerated canaliculi were found where air bubbles came out. Medi soft silicon tube were inducled to supper lacimal canaliculi by 6th pigtail probe. Both upper and lower lacerated lacri- mal canaliculi were anastomosed and the silicon tube were kept for three months. Results The nasal ends of canaliculi in all of the 25 cases were found and anastomosed successfully. Lacrimal duct flushing were fluent months later when the silicon tube were removed. 24 patients had no epiphora （85.71%） and mild epiphora happened in 4 cases （ 14.29% ）. Conclusion It is an effective and simple method to ask patiebts to pinch their noses and hold breath to find the nasal ends of lacerated canaliculi duringery of both upper and lower lacrimal canalicular anastomosis. Soft silicon tube was proved vlinically as an effective support for both upper and lower lacrimal canalicular laceration patients.