两种类型泪道引流管治疗儿童泪小管断裂的临床观察

目的:观察RS-1型泪道引流管与常规硅胶泪道引流管治疗儿童泪小管断裂的临床疗效。方法:回顾性分析2015-01/2018-06河北省眼科医院眼外伤科儿童泪小管断裂患者48例48眼,按治疗方法分成两组:A组(常规硅胶泪道引流管组)25例25眼,B组(RS-1型泪道引流管组)23例23眼;两组患者均在全身麻醉下行泪小管断裂吻合术,术后3mo拔管,比较两组患者手术时间、临床疗效及并发症。结果:A组手术时间为44.92±14.45min,B组为31.78±7.40min(t=4.02,P<0.01);A组:20眼治愈(80%),2眼好转(8%),3眼未愈(12%),治疗有效率为88%;B组:19眼治愈(82%),2眼好转(9%),2眼未愈(9%),治疗有效率为91%(χ2=0.14,P>0.05)。并发症情况:A组下泪点及眼睑轻度外翻1眼(4%),泪小管撕裂2眼(8%),泪道置管脱落2眼(8%),鼻黏膜损伤3眼(12%),并发症总发生率32%;B组:下泪点及眼睑轻度外翻1眼(4%),泪小管撕裂1眼(4%),并发症总发生率9%(χ2=3.94,P<0.05)。结论:RS-1型泪道引流管与常规硅胶泪道引流管在儿童泪小管断裂吻合术中应用效果均良好,但RS-1型泪道引流管操作更简便,手术时间更短,并发症更少,更容易拔管。

Management of pediatric canalicular lacerations with the RS-1 silicone tube and the conventional silicone tube

AIM:To evaluate the clinical effecacy of the RS-1 silicone tube and the conventional silicone tube in the management of pediatric canalicular lacerations.METHODS:We retrospectively reviewed the medical records of 48 pediatric patients(48 eyes)with canalicular lacerations admitted for primary repair in the Department of Ocular Trauma of Hebei Eye Hospital from January 2015 to June 2018.The patients were divided into two groups according to the treatment of method:Group A(25 patients,the conventional silicone tube),Group B(23 patients,the RS-1 silicone tube).The management of pediatric canalicular lacerations were performed under general anesthesia.The silicone tube was removed about 3mo after surgery.The surgical time,clinical efficacy and complications were compared.RESULTS:The mean surgical time between the two groups was 44.92±14.45min in Group A and 31.78±7.40min in Group B,which was statistically significant difference(t=4.02,P<0.01).The clinical efficacy of the two groups was compared.Group A:20 patients were cured(80%),2 patients were improved(8%),3 patients were failed(12%),and the functional success rate was 88%.Group B:19 patients were cured(82%),2 patients were improved(9%),2 patients were failed(9%),the functional success rate was 91%,which was not statistically significant difference(χ2=0.14,P>0.05).The incidence of complications(32%vs 9%)including lower lacrimal point and mild eyelid eversion(1 patient 4%vs 1 patient 4%),slit canaliculus(2 patients 8%vs 1 patient 4%),early tube extrusion(3 patients 12%vs 0%),and nasal mucosal injury(3 patients 12%vs 0%)in Groups A and B,respectively,were comparable.There was statistically significant difference in the incidence of complications between the groups(χ2=3.94,P<0.05).CONCLUSION:There is no statistically significant difference with the two different types of silicone tube,which have good clinical efficacy,in the management of pediatric canalicular lacerations.But the RS-1 silicone tube is easier to operate,shorter surgical time,less complications and easier to removed.