改进型探针在治疗泪小管断裂中“同步插管”的临床应用

目的 评估以新型改进型探针吻合断裂泪小管的术中及术后的效果.方法 纳入了49例下泪小管断裂患者,将“同步插管”方式的改进型探针和传统的猪尾探针行手术对比.观察术中效果差异,并在术后3个月及12个月进行临床效果评价.结果 观察组平均置管时间(10.05±1.51)min,对照组为(32.30±4.70) min,比较差异有统计学意义(t=23.63,P＜0.01);观察组总体手术时间为(32.91±3.98)min,对照组为(53.74±5.48)min,比较差异有统计学意义(t=15.71,P＜0.01).观察组的解剖通畅率发功能通畅率为100.0％(22例)和90.9％(20倒),较对照组明显提高(70.4％,19例;59.3％,16例),差异有统计学意义(x2 =5.77、6.23,P＜0.05).泪点扩张器在观察组中使用18次,对照组中13次,比较差异有统计学意义(x2=5.91,P＜0.05),但均未使用泪小点切开.术后3个月测定的解剖及功能成功率、术中一次性探通成功率和最终探通成功率、术后的并发症等比较差异无统计学意义(P＞0.05).结论 改进型探针提供了一种“同步插管”的新型手术方式,简化了手术步骤,提高了手术成功率,减少了术后并发症的发生.

Clinical application of modified probe synchronous intubation in treating canalicular laceration

Objective To evaluate the intraoperative and postoperative effects of new type and modified probe in fractured lacrimal duct anastomosis.Methods Forty-nine patients with lower canalicular laceration were included in this study.The operation comparison was performed between the modified probe in a manner of synchronousintubation and the traditional pigtail probe.The differences of intraoperative effects were observed,and the clinical effects were assessed at postoperative 3,12 months.Results The average intubation time was (10.05±1.51) min in the observation group and (32.30±4.70) min in the control group,the difference was statistically significant (t=23.63,P＜0.01),the average whole operation time was (32.91 ± 3.98) min in the Observation group and (53.74± 5.48) min in the control group,the difference was staustically significant (t=15.71,P＜0.01).The rates of anatomic and functional success were 100.0％ (22 cases) and 90.9％ (20 cases) in the observation group,which were significantly higher than 70.4％ (19 cased) and 59.3％ (16 cases) in the control group,the difference was statistically significant (x2 =5.77,P＜0.05;x2 =6.23,P＜0.05).The punctal dilator was used by 18 times in the observation group and by 13 times in the control group,the difference was statistically significant (x2=5.91,P＜0.05),nevertheless no punctal incision was used.The rates of anatomic and functional success detected at 3 postoperative months,intraoperative once success and final success rates and postoperative complications showed no statistically significant differences(P＞0.05).Conclusion The modified probe provides a synchronous intubation new type operation mode,which simplifies the operation procedure,increases the operative success rate and partially reduces the occurrence of postoperative complications.