急诊显微手术治疗泪小管断裂

Anastomosis of the disrupted canalienlus on emergency under operating microscope

目的探讨泪小管断裂断端的找寻规律和防止术后瘢痕收缩的方法,提高急诊泪小管断裂吻合术的成功率。方法在眼科手术显微镜下仔细寻找11例泪小管断裂患者(含年龄9个月者)的泪小管断端,以硬膜外麻醉导管作支撑管,以眼科9-0尼龙线行三点对位吻合,支撑管留置至术后20～90d。结果11例均成功吻合泪小管,术后20d至3个月拔管后无泪溢。结论术中耐心寻找泪小管断端,仔细对位缝合皮肤,术后以硬膜外麻醉导管作留置支撑管可以提高手术成功率。

Objective In order to increase the success rate of canalicular anastomosis -searching for regularity of the medial broken end of the disrupted canaliculus and putting a tube to preventing atresia.Methods Carefully searching for the medial broken end of the canaliculus under operating microscope together with putting a tube as a temperary internal stent to reestablish the patency of the lacerted canaliculus was performed in the 11 patients(including a patient of age of 9 days); the tube was preserved for 20-90 days after operation.Results All the 11 consecutive cases subjected to anastomosis operation were successful at just once operation- after extraction of the tube within 20-90 days- no lacrima was run.Conclusion Mastering the morphological characteristics of the broken end and using operating microscope and preventing atresia could increase the success rate of this operation