环形硅胶双泪道引流管与硬膜外麻醉导管治疗外伤性泪小管断裂的疗效观察

目的：探讨环形硅胶双泪道引流管与硬膜外麻醉导管治疗外伤性泪小管断裂的疗效和特点。方法：回顾分析2009-01/2013-12我科收治的外伤性泪小管断裂患者62例62眼,其中环形硅胶双泪道引流管组32例32眼,硬膜外麻醉导管组30例30眼。所有患者均在显微镜下寻找到断端并顺利实施吻合手术。对两种手术方式的手术时间、术后反应、术后效果及并发症等情况进行回顾性分析。结果：环形硅胶双泪道引流管组的手术时间为55~120(平均85.17±15.05) min,硬膜外麻醉导管组的手术时间为30~70(平均49.83±10.71)min。环形硅胶双泪道引流管组术后1wk吻合口红肿4例(12.5％),硬膜外麻醉导管组术后1 wk吻合口红肿24例(80％)。拔管后1 wk冲洗泪道,环形硅胶双泪道引流管组有效31例(97％),硬膜外麻醉导管组有效26例(87％)。环形硅胶双泪道引流管组术后6mo 眼睑外翻2例(6％),泪小点撕裂1例(3％)。硬膜外麻醉导管组术后6mo 眼睑外翻10例(33％),泪小点撕裂5例(17％)。结论：环形硅胶双泪道引流管与硬膜外麻醉导管均可用于治疗外伤性泪小管断裂,均可获得良好的效果,环形硅胶双泪道引流管术后反应轻,术后并发症少,但手术时间长,硬膜外麻醉导管手术时间短,但术后反应重,并发症多。

Observation of silicone tube double-passage annular lacrimal intubation and epidural catheter for repairing the traumatic lacrimal rupture

AIM:To evaIuate the efficacy and characteristics of siIicone tube doubIe-passage annuIar IacrimaI intubation and epiduraI catheter for repairing the traumatic IacrimaI rupture. METHODS:Retrospective case study. Sixty-two cases (62 eyes) with traumatic IacrimaI rupture were invoIved in the study from January 2009 to December 2013. Thirty-two cases ( 32 eyes ) were treated with siIicone tube doubIe-passage annuIar IacrimaI intubation, 30 cases ( 30 eyes) with epiduraI catheter. AII cases were underwent anastomosis surgery successfuIIy after having searched for the broken ends of canaIicuIus by operation microscope. The operation time, postoperative reaction, efficacy, compIications and so on were retrospectiveIy anaIyzed between two methods. RESULTS:The operation time of siIicone tube doubIe-passage annuIar IacrimaI intubation group was 55 ~ 120 (85. 17±15. 05)min and epiduraI catheter group was 30~70 (49.83±10. 71)min. Four cases (12. 5%) in siIicone tube doubIe - passage annuIar IacrimaI intubation group happened postoperative anastomotic infIammation in 1wk and 24 cases (80%) happened in epiduraI catheter group.Thirty-one cases ( 97%) in siIicone tube doubIe-passage annuIar IacrimaI intubation group and 26 case ( 87%) in epiduraI catheter group were anastomosed successfuIIy 1wk after the stents was removed. At 6mo after surgeries, in siIicone tube doubIe - passage annuIar IacrimaI intubation group, 2 cases ( 6%) were accompanied by Iower eyeIid ectropion and 1 case ( 3%) were accompanied by IacrimaI puncta Iaceration. And in epiduraI catheter group, 10 cases ( 33%) were accompanied by Iower eyeIid ectropion and 5 case (17%) were accompanied by IacrimaI puncta Iaceration. CONCLUSION:A good resuIt can be obtained by using the siIicone tube doubIe - passage annuIar IacrimaI intubation and epiduraI catheter for repairing the traumatic IacrimaI rupture. But in siIicone tube doubIe-passage annuIar IacrimaI intubation group, postoperative reaction is Iighter and compIications can be Iess. In epiduraI catheter group, postoperative reaction is heavy and compIications are more.