无鼻内窥镜下RS置管术治疗泪小管断裂的临床疗效

目的：探讨无鼻内窥镜下RS置管术治疗泪小管断裂的临床疗效。

方法：回顾性分析我院2017-09/2018-03收治的泪小管断裂患者52例52眼。根据入院时间顺序分为两组，RS管组32例32眼，环形泪道置管组20例20眼。对比分析两组患者的术中鼻出血、临床疗效和术后并发症情况。

结果：RS管组术中无鼻出血发生，环形泪道置管组鼻黏膜出血15眼，两组差异有统计学意义(P<0.001)。RS管组治愈26眼，好转3眼，无效3眼，治疗有效率为91%； 环形泪道置管组治愈15眼，好转3眼，无效2眼，治疗有效率为90%，两组临床疗效差异无统计学意义(P=0.877)。术后2wk～2mo，RS管组脱管2眼，有1眼在留置未满2wk时从泪小点脱出，给予再次吻合； 另有1眼在术后1～2mo内从泪点抽出，未再次手术，随访时泪道冲洗好转。环形泪道置管组脱管3眼，未再次手术，在以后的随访过程中泪道冲洗好转。两组患者术后并发症差异无统计学意义(P=0.361)。

结论：泪小管断裂需及时手术治疗，采用RS管能提高手术成功率，降低并发症的概率，并且具有操作方法简单、组织相容性好、不影响患者外观等优点。

Clinical outcomes of RS lacrimal tube for lacrimal canaliculi rupture without nasal endoscope

AIM:To explore the clinical outcomes of RS lacrimal tube for lacrimal canaliculi rupture without nasal endoscope.

METHODS:A retrospective analysis from September 2017 to March 2018 were taken. According to admission time sequence. Totally 52 patients with lacrimal canaliculi rupture was divided into two groups. One group was treated with RS lacrimal tube, the other was treated with annular silicone tube. The treatment results were comparatively analyzed.

RESULTS:There were 15 eyes of nasal mucosa hemorrhage in annular silicone tube group. There was no eye with this in RS tube group, the difference between the two groups was significant(P<0.001). In RS tube group, 26 eyes were cured, 3 eyes improved, 3 eyes failed. The effective rate was 91%. In annular silicone tube group, 15 eyes were cured, 3 eyes improved, 2 eyes failed. The effective rate was 90%, the clinical efficacy was not significantly different between groups(P=0.877). There were 2 eyes in RS tube group occurred fall off in 2wk to 2mo after operations; 1 eye of lacrimal puncture were removed from the lacrimal puncture without 2wk, and was anastomosed again. The other eye was removed from the lacrimal puncture within 1-2mo after the operation, the lacrimal canal flushing was improved during follow-up. There were 3 eyes in annular silicone group occurred fall off without 2wk, and were not anastomosed again. The lacrimal duct flushing was improved during follow-up. No statistical significance was found in the two groups(P=0.361).

CONCLUSION:Lacrimal canaliculi rupture should be timely given surgical treatment. RS lacrimal tube can not only achieve good operation effect and reduce the probability of complications, but also has the advantages of simple surgical methods, good histocompatibility and no influence on the appearance of patients.