经皮肤一针吻合并双泪小管置管法修复上下泪小管同时断裂

One-stitch anastomosis through the skin with bicanalicular silicone tube intubation for treatment of superior and inferior canalicular lacerations

目的探讨“经皮肤一针吻合并双泪小管置管法”修复上下泪小管同时断裂的手术的效果。方法回顾性分析11例（11眼）采用“经皮肤一针吻合并双泪小管置管法”修复的上下泪小管同时断裂病例的资料。手术显微镜下分别找到上下泪小管的颞侧和鼻侧断端，用直径为0．8mm硅胶管作为支架插入拟吻合的泪小管，用5—0丝线分别经皮肤吻合上、下泪小管断端各1针。术后3个月拔除泪小管支架，随访时间3—36个月。结果11例中，治愈9例，基本治愈1例，无效1例。所有病例眼睑伤口愈合良好，无眼睑或内眦外伤性畸形。无并发泪点撕裂者，无自行意外拔出硅胶管者。结论本手术能直接同时吻合断裂的上下泪小管，且硅胶管隐蔽。伤口无长期存留缝线，避免了缝线引起的炎性肉芽肿而造成的泪小管狭窄或阻塞。

Objective To evaluate the efficacy of one-stitch anastomosis through the skin with bi- canalicular silicone tube intubation to treat the bicanalicular lacerations. Methods Retrospectively, 11 consecutive patients with both superior and inferior canalicular lacerations in one eye who underwent surgical repair using one-stitch anastomosis through the skin and bicanalicular stent were included. All the operations were performed under surgical microscope, 5 - 0 silk sutures were used and bicanalicular silicone tubes （ the diameter was 0.8 mm） were intubated, with one lacerated canalicula one-stich anastomosis through the skin. The stents were left in the place for 3 months postoperatively and then were removed. The follow-up period was 3 -36 months（average 14 months ）. Results In 11 patients, 9 patients were cured entirely, 1 patient were meliorated, 1 patient had no effects. All the patients had got good recovery of eyelid laceration without traumatic deformity in eyelid or canthus. There was no early tube protrusion or punctal slits in the patients. Conclusion One-stitch anastomosis through the skin with bicanalicular silicone tube intubation is a good method in repair of bicanalicular laceration in one eye. The cut ends could be anastomosed directly. No su- ture remained in the wound permanently. There was no suture-related granuloma which might cause obstruc- tion or stenosis of canaliculi.