鼻内镜下双泪小管植入泪道引流管治疗泪小管断裂的疗效分析

The curative effect ananlysis of lacrimal duct fracture was treated by bilateral duct implantation under the nasal endoscope

目的探讨鼻内镜下双泪小管植入泪道引流管治疗泪小管断裂的临床疗效。方法对73例(73只眼)外伤性泪小管断裂患者,根据泪小管支架不同分两组,第一组33例采用腰麻导管做支撑行下泪小管断裂吻合术;第二组40例采用鼻内镜下泪道引流管双泪小管插管吻合断裂泪小管。随访6个月至3年,对比两种方法在手术时间、有效率、泪小点豁开情况、支架脱落情况和内眦眼睑畸形愈合情况。结果第一组手术时间(68. 06±4. 69) min,有效26例(78. 8%),无效7例(21. 2%),泪点豁开6例(18. 2%),泪小管支架脱落11例(33. 3%),术后眼睑畸形4例(12. 1%),第二组手术时间(84. 25±5. 04) min,有效38例(95%),无效2例(5%),泪点豁开2例(5%),泪小管支架脱落1例(2. 5%),术后眼睑畸形1例(2. 5%),术后6个月,两组对比,第二组手术时间较第一组手术时间长,第二组有效率高于第一组,泪点豁开比率低于第一组,支架脱落率低于第一组,具有统计学意义(P<0. 05),眼睑畸形率无统计学意义。结论鼻内镜下双泪小管植入泪道引流管治疗泪小管断裂的方法效率高,术后并发症少,值得推广。

Objective To observe the clinical efficacy of silicone tube in reconstructing traumatic canalicular laceration. Methods This interventional case series enrolled 73 patients with a traumatic canalicular laceration. Patients with bicanalicular involvement were excluded. The patients were divided into two groups, 33 cases in Group one were used in epidural tubes, 40 cases in Group two were used the lacrimal drainage tubes to repair canalicular under the nasal endoscope. Canalicular repair was performed under an operating microscope. The patients were followed up for 6 months to 3 years. T and the two methods were compared in terms of operation time, efficiency, lacrimal puncture gap, stent detachment and inner canthus eyelid malformation. Results In Group one, the average operation time was 68.06±4.69 min, 26 cases were cured(78%), the lacrimal punctum of 6 cases were lacerated (18.2%), stent loss in 11 cases(33.3%) and postoperative eyelid deformity in 4 cases(12.1%),In group two the average operation duration was 84.25±5.04 min, effective 38 cases (95%), 2 cases of lacrimal stent into tears(5%), tubular loss in 1 cases (2.5%)and postoperative eyelid deformity in 1 cases(2.5%),All the comparisons in two groups were statistically significant( P <0.05), except eyelid deformity. Conclusions Using endoscope-assisted drainage tube double-passage intubation in anastomosis for lacrimal canalicular laceration has better operative effect and less complication occurs. It's worthy to be popularized.