小儿外伤性泪小管断裂吻合术失败原因分析

目的分析儿童外伤性泪小管断裂吻合术失败的原因，通过改良支架放置方法，提高儿童泪小管断裂吻合术的成功率。方法儿童行泪小管断裂吻合术共25例（25眼），对其中失败病例10例进行分析，找出导致手术失败的主要原因。结果25例中16例采用常规的外露支架放置法病例中，术后1周内支架脱出5例，行泪道冲洗均不通畅；1个月后支架脱出5例中3例冲洗不通畅。9例采用潜行支架放置法病例中，2例因塑料管将下泪小管割裂后脱出，泪道冲洗不通畅。结论造成小儿外伤性泪小管断裂吻合术失败的主要原因为支架放置不当，导致支架提前脱出。潜行支架放置法，可提高儿童外伤性泪小管断裂吻合术的成功率。

Cause of failure in anastomosis of pediatric traumatic canalicular laceration

Objective To analyze the failure in anastomosis of pediatric traumatic canalicular laceration and increase the rate of success by improving the stent replacement.Methods There were 25 cases (25 eyes) of anastomosis of pediatric traumatic canalicular laceration and 10 of which were failed after surgery,To analyze the 10 cases and find out the main cause of failure.Results Among the 25 cases,there were 16 cases used the conventional method of exposed stent placement.5 cases' stents were slided in 1 week postoperatively with blocked lacrimal irrigation.5 cases' stents were slided in 1 month postoperatively and 3 cases' lacrimal irrigation were blocked.The other 9 cases used the method of potential stent placement,2 cases'stents slided because plastic pipe separated lower lacrimal canaliculi which lead to lacrimal irrigation blocked.Conclusion The main cause of failure in anastomosis of pediatric traumatic canalicular laceration was the improper placement of stent and prolapse in advance.The rate of success could be increased by using improving stent replacement.