儿童和青少年泪小管断裂的手术治疗

目的 分析全麻或基础麻醉下行儿童和青少年泪小管断裂吻合术的特点,探讨采用缝合固定于鼻前庭的人工泪管(硅胶管)植入的效果.方法 全麻或局部麻醉联合基础麻醉支持下,对16例(16只眼)儿童和青少年(3～15岁)泪小管断裂者行泪小管吻合,术中采用硬膜外麻导管将带线硅胶管引导入泪道作为泪道支撑物,人工泪管两端分别通过上、下泪小点植入鼻泪道并固定于鼻前庭.结果 术后随诊观察10.5月(3月至3年),15例术后泪道冲洗通畅,1例出现轻度溢泪,泪道冲洗不通,成功率93.7%.16例患儿人工泪管均在位,均在预期时间拔管.结论 全麻或基础麻醉下行儿童和青少年泪小管断裂吻合术,采用带线硅胶管作为泪道支撑物能较好保持儿童和青少年患者人工泪管位置,手术成功率高.

Surgical repair of the laceration of the lacrimal canalicalus in children and adolescents

Objective To study the effect and characteristics of lacrimal canaliculus anastomosis with artificial lacrimal canaliculus under general anesthesia in children and adolescents. Methods Sixteen children and adolescents (aged from 3-15 years old) who consecutively underwent lacrimal canaliculus anastomosis in general anesthesia. During surgeries artificial silicone tube as lacrimal canalieulus were used. The silicone tube was sutured in nasal vestibule during the operation. Results After 3 month to 3 years follow-up period, 15cases were unobstructed, without epiphora, while 1 case was some obstructed when syphilis of lacrimal passagers with some epiphora. The final cured rate was 93.7% (15/16). The silicone tube of most cases kept stable within 2 months post-operatively. Conclusions The effect of lacrimal canaliculus anastomosis with artificial silicone tube under general anesthesia to children and adolescents is well. The silicone tube can be stable within 2 months post-operatively.