泪小管断裂78例的原因与临床处理

Reasons and clinical managements of canalicular laceration in 78 cases

目的: 分析泪小管断裂原因,探讨提高泪小管断裂吻合术成功率的手术方法和技巧。方法: 泪小管断裂患者78例78眼,均Ⅰ期显微镜下经硬膜外导管支撑行泪小管断裂吻合术。结果: 全部患者均成功吻合,术后3mo拔管,随访至1a,下泪小管均通畅。结论: 泪小管断裂绝大部分为钝挫撕裂伤。显微镜下Ⅰ期吻合是首选和必须的方法,鼻侧断端的寻找、硬膜外导管的确切植入、内眦的解剖复位是手术成功的关键。假泪点同样可以引流泪液。

·AIM： To analyze the reason of canalicular laceration, and to explore the methods and techniques to raise the success rate of lacrimal canaliculi laceration anastomosis. ·METHODS： Seventy- eight cases （78 eyes） with canalicular underwent lacrimal canaliculi laceration anastomosis through catheter support under microscope at I stage. · RESULTS： The operation was successful in all cases.The extubation time was at 3 months after operation. After one-year follow-up, lower lacrimal canaLiculi were all unobstructed. · CONCLUSION; The causes of canalicular laceration laceration mostly were frustrated laceration. Receiving anastomosis under microscope at I stage was preferred and necessary. Searching nasal stump, implanting epidural catheter and anatomical reduction of the inner canthus were the keys to make the operation successful. Fake tears could also drain tear.