上颌骨骨折合并泪道损伤的早期处理及意义

目的:探讨上颌骨骨折合并泪道损伤的处理方法,以及早期处理的重要性。方法:回顾分析27例上颌骨骨折合并泪道损伤的临床资料,按外伤后治疗时间早晚分为2组:伤后10d以内组和10d以后组。泪道损伤患者根据不同的损伤情况给予局部抗生素点眼,冲洗泪道和泪道置管、泪小管吻合术、激光泪道成形术等相应手术治疗,以患者溢泪消失、泪道冲洗通畅为治愈指标。采用χ2检验分析2组间的疗效差异。结果:10d以内组16例经治疗,15例泪道通畅;10d以后组11例经治疗,5例泪道通畅。2组间差异有显著性(P<0.05)。结论:上颌骨骨折合并泪道损伤应引起口腔颌面外科医生的足够重视,早期诊断、早期治疗可获得良好的治疗效果。

Early management of maxillary fracture combined with lacrimal path damage and its clinical significance

PURPOSE:To investigate the early management of maxillary fracture combined with lacrimal path damage and its clinical significance.METHODS:92 cases of maxillary fracture were analyzed retrospectively,among which 27 cases had concomitant lacrimal path damage.The 27 cases were divided into two groups according to the diagnosis and treatment time(within 10 days and over 10 days)of lacrimal path damage.Treatment methods included antibiotic eyedrops,lacrimal path irrigation,anastomosis,endolacrimal recanalisation by Nd:YAG laser,etc.Evaluation criteria of cure included epiphora resolution and unobstructed lacrimal path confirmed by irrigating.The data were analyzed by Chi-square test.RESULTS:In 16 cases of maxillary fracture combined with lacrimal path damage who received early treatment within 10 days,only one case remained epiphora;while among 11 cases who received delayed lacrimal treatment 10 days or even longer after the injury,only 5 cases kept lacrimal path unobstructed(P<0.05).CONCLUSION:Early diagnosis and treatment(within 10 days)of lacrimal path damage is important for the outcomes of maxillary fracture combined with lacrimal path damage.