硅胶管双路置管与硬膜外麻醉管单路置管行泪小管断裂吻合术的临床观察

CLINICAL OBSERVATION OF DOUBLE CANALICULAR ANNULAR SILICONE TUBE AND EPIDURAL ANESTHESIA TUBE IN ANASTOMOSIS FOR LACRIMAL CANALICULAR LACERATION

目的：观察硅胶管双路置管与硬膜外麻醉导管单路置管在泪小管断裂吻合术中的疗效。方法：使用硅胶管双路置管35例（35眼）为A组,硬膜外导管单路置管30例（30眼）为B组。随访6-12mo,观察溢泪情况、眼睑形态、泪道通畅情况及是否出现并发症。结果：随访6-12mo,A组：1例（1眼）冲洗泪道欠通畅,1例（1眼）冲洗泪道不通畅且溢泪,33例（33眼）无溢泪,外形正常,冲洗泪道通畅,无并发症发生;B组：3例（3眼）冲洗泪道欠通畅,1例（1眼）冲洗泪道不通畅且溢泪,2例（2眼）出现泪小点豁开,2例（2眼）出现轻度睑外翻和泪小点外翻,1例1眼自行拔除硬膜外麻醉导管致手术失败,26例（26眼）无溢泪,外形正常,冲洗泪道通畅。A组与B组治愈率及有效率比较差异无统计学意义（P〉0.05）,两组并发症比较差异有统计学意义（P〈0.05）。结论：两组治疗效果相当,而硅胶管双路置管并发症少,可靠,值得推广应用。

Objective：To observe the effect of double canalicular annular silicone tube and epidural anesthesia tube in anastomosis for lacrimal canalicular laceration. Methods：35 cases （ 35 eyes）of double canalicular annular silicone tube were classified into group A;30 cases（30 eyes） of epidural anesthesia tube were classified into group B. Both the groups were followed up for 6 -12months,observing the situations of epiphora,eyelid shape,lacrimal duct flowing. Results：After 6-12months followed-up,group A：1 case of lacrimal duct flushing was a little free,1 case of lacrimal duct flushing was little free and clear tears overflowed,33 cases of lacrimal duct flow had no tears overflow without complication and eyelid shape remained normal;group B：3 cases of lacrimal duct flushing were a little free,1 case of lacrimal duct flushing was little free and clear tears overflowed,2 cases were lacrimal punctum gapping,2 cases were ectropion of eyelid and lacrimal punctum,1 case was failure because of tube drawing by himself,26 cases of lacrimal duct flow had no tears overflow without complication and eyelid shape remained normal. The difference of cure rate between group A and group B had no statistical significance（P〉0. 05）but the incidence of complications had statistically significant differences（P〈0. 05）. Conclusion：The therapeutic effect between two groups showed no difference,however,less complications appeared in double canalicular annular silicone tube which was more reliable and should be widely applied.