泪小管修复术不同泪道支撑管的效果及其影响因素分析

Analysis of the efficacy and influencing factors of different lacrimal duct stent in the repair of laceration of lacrimal canaliculus

目的分析泪小管断裂吻合术不同泪道支撑管的效果及影响效果的因素。方法回顾性病例研究。以2019年1月至2020年1月开封眼病医院泪小管断裂吻合术80例(80眼)作为研究对象。患者分为两组:A组39例,以硬膜外麻醉管为支撑管;B组41例,以双回路泪小管环形硅胶管作为支撑管。术后随访3个月,观察两组疗效及其影响因素。结果随访期末,A组的总有效率为84.62%(33/39),显著低于B组的97.56%(40/41)(χ^(2)=4.195,P=0.041);A组的痊愈率为64.1%(25/39),显著低于B组的92.68%(40/63)(χ^(2)=9.756,P=0.002);未痊愈组患者受伤至手术时间低于24 h者占29.41%(5/17),明显低于痊愈组的63.49%(40/63)(χ^(2)=6.318,P=0.012);痊愈组患者的断裂位置为近端者占52.38%,明显高于未痊愈组的11.76%(2/17)(χ^(2)=3.335,P=0.001)。结论泪小管断裂吻合术效果受到断裂至手术时间、断裂的位置等因素的影响。双回路环形硅胶管作为支撑管的效果更好.

Objective To analyse the efficacy and influencing factors of different lacrimal duct stent in the repair of laceration of lacrimal canaliculus.Methods This was a retrospective case study.A total of 80 eyes of 80 cases of anastomosis of lacrimal canaliculus from Jan.2019 to Jan.2020 in Kaifeng Central Hospital were included as the research objects.All patients were divided into two groups:Group A included 39 cases with epidural anesthesia tube as support stent;Group B included 41 cases with dual-circuit lacrimal canaliculus ring silicone tube as support stent.These cases were followed up for 3 months after operation.The efficacy and influencing factors of the two groups were observed.Results At the end of the follow-up period,the total effective rate of group A was 84.62%(33/39),which was significantly lower than the 97.56%(40/41)of group B(χ^(2)=4.195,P=0.041).The cure rate of group A was 64.1%(25/39),which was significantly lower than the 92.68%(38/41)of group B(χ^(2)=9.756,P=0.002).The ratio of patients who received operation after injury within 24 hours in the uncovered group was 29.41%(5/17).which was significantly lower than the 63.49%(40/63)in the cured group(χ^(2)=6.318,P=0.012);The fracture position in the near end of the cured group accounted for 52.38%(33/63),which was significantly higher than the 11.76%(2/17)in the unhealed group(χ^(2)=3.335,P=0.001).Conclusion The efficacy of anastomosis of lacrimal canaliculus laceration is affected by factors such as the time from rupture to operation and the specific injury location.Double loop silicone tube is better as a support tube than epidural anesthesia tube.