摘要
目的 探讨硬膜外麻醉导管植入治疗外伤性下泪小管断裂的远期疗效。方法 下泪小管断裂 42例 ( 4 2眼 ) ,均于伤后 48小时内手术 ,在显微镜下找到下泪小管断端 ,插入硬膜外麻醉导管并吻合。导管上端的处理 :2 5眼用缝线或胶布固定 ;12眼烧灼导管上端 ,使膨大呈直径大于泪点的圆球状 ;4眼环行管。术后 2～ 3月拔管并随访 12～ 2 4月。结果 远期治愈3 1眼 ( 73 81% ) ,好转 8眼 ( 19 0 5 % )。主要并发症为下泪点及其近端撕裂 15眼 ( 3 6 5 9% ) ,采用导管上端烧灼呈球状膨大者 ,泪点撕裂的机率较少。结论 硬膜外麻醉导管植入吻合术治疗外伤性下泪小管断裂有效可行 ,远期主要并发症为下泪点及近端撕裂。
Objective To evaluate the long_term effectiveness of repairing the inferior canalicular lacerations by intubation.Methods The intubation were proformed under microscope in 42 cases (42 eyes) of canalicular lacerations within 48 hours after injured,The upper end of the tube were fixed on the skin by adhesive plaster or stitch in 25 cases,buried as punctual plug in 12 cases, ring_formed into the lacrimal sac in 4 cases. The tube's position were maintained for 2-3 months and the follow up period were 12-24 months.Results 73.87% (31/42) eyes were unobstructed on irrigation and no epiphora,19.05% (8/42) eyes were improved (unobstructed on irrigation but sometimes epiphora). There were 36.59% (15/42) eyes had incidence of iatrogenic damage to the lacremal point and near canaliculus, most of the damage occurred in the tube fixed on the skin by adhesive plaster or stitch group(12/25),and it were lucky 66.67% (10/15) of it remained asymptomatic,secondary to a functioning conjunctival canalicular fistula,or the patent remaining canaliculus. Conclusions The inferior canalicular lacerations can be repaired by the intubation, but the tube may cause damage to the lacremal point and near canaliculus in some cases.
出处
《眼外伤职业眼病杂志》
北大核心
2004年第4期251-252,共2页
Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries
