羊膜修复外伤复杂性泪小管断裂22例

背景：外伤复杂性泪小管断裂由于存在组织的缺损,临床修复较难。许多研究表明羊膜具有促进上皮化,抑制炎症反应和纤维化的功能。目的：观察羊膜修复外伤复杂性泪小管断裂的效果。方法：外伤复杂性泪小管断裂的患者22例,均具有泪小管断裂合并泪小点损伤及泪小管缺损,其中9例合并泪小点劈裂,5例合并泪小点缺损,8例泪小管段性缺损。对以上患者采用羊膜修复联合泪小管断裂吻合置管术进行治疗。术后4月拔除置管,于拔管后第1,2,4周,第2,3个月复查,随访7~18个月,观察患者流泪,泪道冲洗及泪液清除率的变化,并评价其疗效。结果与结论：至随访时间：治愈21例(95%),好转1例;14例泪小点重建者泪小点形成良好(100%);21例泪液清除率正常。结果提示,应用羊膜联合泪小管断裂吻合置管术对外伤复杂性泪小管断裂进行联合修复成功率较高,疗效较好。关键词：羊膜;修复;泪小管断裂;泪小管断裂吻合术;组织构建

Amniotic membrane for repair of canaliculus lacrimalis laceration in 22 cases

BACKGROUND: It is difficult to repair complex canaliculus lacrimalis laceration due to tissue defect. Previous studies demonstrated that amniotic membrane can facilitate epithelization and inhibit inflammatory reaction or fibrosis.OBJECTIVE: To evaluate the clinical efficacy of amniotic membrane transplantation (AMT) on the repair of canaliculus lacrimalis laceration. METHODS: A total of 22 eyes of 22 patients of canaliculus lacrimalis laceration, including 9 cases combined with lacrimal point splitting, 5 with lacrimal point defect, and 8 with canalicular defects. AMT combined with canaliculoplasty were applied for the treatment. The tube was removed at 4 months after operation, and the re-examination was performed at 1, 2, 4 weeks and 2, 3 months after tube removal. The follow-up lasted for 7-18 months. The therapeutic effect was evaluated. RESULTS AND CONCLUSION: Up to the end follow-up, 21 of 22 cases (95.45%) were recovered, and 1 case went better. A total of 14 cases (100%) reconstruction of lacrimalis puncticulum were very well. 21 cases tear clearance rate were normal. The findings demonstrated that AMT combined with canaliculoplasty are a safe and effective surgery for the reconstruction of canaliculus lacrimalis laceration.