改良双路硅胶支撑管置管术治疗泪小管断裂

目的 评价改良双路硅胶支撑管置管法治疗泪小管断裂的临床疗效.方法 52例（52眼）泪小管断裂手术,A组25例,采用传统腰麻导管做支撑管,单路插管后行泪小管吻合术;B组27例,采用双路硅胶支撑管置管术,并用改良手术方法吻合泪小管.术后随访3～18月,比较两种方法在手术时间、治愈率、泪点及泪小管撕裂等3个方面差异.结果 A组手术时间（71.80±36.22）min,完全治愈13例,无效4例,泪点及泪小管撕裂8例.B组手术时间（108.78 ±57.01） min,完全治愈23例,无效0例,泪点及泪小管撕裂2例.B组较A组手术时间有所延长,但其手术治愈率高于A组,泪点及泪小管撕裂率低于A组,差异均具有统计学意义.结论 改良双路硅胶支撑管置管治疗泪小管断裂方法简单、实用,疗效好,并发症少.

Improved intubation with double-passage silicone stent for lacrimal canalicular laceration

Objective To evaluate the clinical efficacy of improved silicone stent double-passage intubation for the treatment of lacrimal canalicular laceration. Methods Fifty-two eyes of 52 patients with lacrimal canalicular laceration were divided into two groups. 25 patients of group A were treated by using traditional epidural anesthetic tube as stent and underwent the lacrimal canalicular anastomosis surgery after single nasolacrimal duct intubation. 27 cases of group B were treated by improved surgical method wihch was double-passage intubation with silicone tube as support. After follow-up of 3 --18 months, the differences of two groups in operation duration, operative cure rate and percentage of lacrimal punctum and lacrimal canaliculus lacerated were compared. Results In group A, the average operation duration was （71.80 ± 36.22 ） min, 13 cases were completely cured, and the lacrimal puncture and lacrimal canaliculus of 8 cases were lacerated. In group B, the average surgery time was （ 108.78± 57.01 ） min, the number of cases completely healed was 23, and the number of torn lacrimal point and ductule was 2. Compared with group A, the operation time of group B was extended, but the cure rate was higher and the probability of lacrimal punctum and canaliculus torn was lower, and the differences were statistically significant. Conclusion In the treatment of lacrimal canalicular laceration, the method of improved silicone stent double-passage intubation is simple, practical, effective and has less complications.