两种不同手术方法治疗泪小管断离的临床分析

Clinical analysis of two different surgical methods in the treatment of canalicular laceration

目的观察两种不同手术方式治疗泪小管断离的临床疗效。方法在住院治疗的泪小管断离共60例(60眼),随机分为两组:A组30个病人(30只眼)硬膜外麻醉导管治疗泪小管断离;B组30个病人(30只眼)crawford管治疗泪小管断离。根据病情平均3-6个月拔管,拔出泪道硅胶管后,泪道冲洗通畅且无症状为治愈;泪道冲洗通畅,但有一定阻力且偶有流泪为好转;泪道冲洗不通畅为无效;拔管两个月以上再次流泪冲洗不通畅为复发。结果拔管后,A组:治愈:18眼(60%);好转:6眼(20%);无效:4眼(13.33%);复发:2眼(6.67%)。B组:治愈:26眼(86.67%);好转:2眼(6.67%);无效:1眼(3.33%);复发:1眼(3.33%)。结论鼻内窥镜下crawford管置管是一种有效的治疗泪小管断离的办法。

Objetive To explore the different surgical methods in the treatment of canalicular laceration. Methods 60 cases（60 eyes） diagnosed with canalicular laceration were divided into two groups： A group of 30 patients（30 eyes） underwent canalicular laceration with the epidural anesthesia catheter;B group of 30 patients（30 eyes） underwent canalicular laceration with the crawford lacriamal intubation system. The tubes were left in place between 3 and 6 months. After the extubation clinical success was defined as lacrimal patency. Clinical improvement was defined as lacrimal irrigation with some resistance and sometimes tearing. Lacrimal irrigation was not smooth immediately after surgery was defined as ineffective. Recurrence was defined as lacrimal irrigation was not smooth and tearing again 2 months after extabation. Results After the extabation,Group A＇s successful rate was60%（18eyes）;the improving rate was 20%（6eyes）;on the other hand, ineffective rate was13.33%（ 4eyes）;And the recurrence rate of lower canalicalus obstruction was 6.67%（2eyes）. Group B＇s overall successful rate was 86.67%（26eyes）; the improving rate was 6.67%（2eyes）;on the other hand, ineffective rate was 3.33%（ 1eyes）;And the recurrence rate of lower canalicalus obstruction was 3.33%（1eyes）.ConclusionEndoscopic approach with crawford tube is an effective procedure for the treatment of the canalicular laceration.