浅析单泪道外环路硅胶管插入泪小管吻合术.docVIP

精品论文 参考文献 浅析单泪道外环路硅胶管插入泪小管吻合术 黑龙江省安达市医院 151400 　　摘要：目的 研究分析硅胶管插入泪小管断裂吻合术的特点，探讨采用单泪道外环路硅胶管插入泪小管吻合术的效果及优缺点。方法 此次研究的对象是选择40例（40只眼）下泪小管断裂患者。对其采取直视下行泪小管吻合术，术中将带球形探针的硅胶管插入下泪道作为泪小管支撑物，一端从鼻腔引出，鼻外打结固定。结果 拔管后随访观察平均3.5个月（1个月～1年），治愈39例，无眼睑畸形愈合，冲洗泪道通畅；好转1例，下泪小点外翻，冲洗泪道通畅；无泪小点豁开。结论 单泪道外环路硅胶管插入泪小管吻合术操作难度不大，不用在显微镜下操作，步骤简单，固定容易，不脱管，吻合、对位效果好，因上泪小管不插管，自然开放，术后术眼溢泪不明显，可于门诊治疗，经济实惠，适合基层医院开展。 　　关键词：下泪小管断裂；泪小管断裂吻合术；硅胶管 　　Abstract: Objective To study the characteristics of silicone tube inserted canalicular anastomosis, explore the use of single loop silicone tube inserted outside the lacrimal canaliculus anastomosis effect and advantages. Methods 40 cases (40 eyes) were selected for the study. Take a look of lacrimal duct anastomosis on the intraoperafively silicone tube with spherical probe is inserted into the lower lacrimal canaliculus as support, from one end of the nasal cavity leads, nose fixed knot. Results after extubation were followed up for an average of 3.5 months (1 months to 1 years), 39 cases were cured, no eyelid deformity, unobstructed lacrimal duct; 1 cases were improved, lower punctum ectropion, unobstructed lacrimal duct; no lacrimal point opened. Conclusion the single tear of outer ring silicone tube inserted lacrimal duct anastomosis operation is not difficult, do not operate under the microscope, simple steps, easy fixation, off tube anastomosis, alignment effect is good, because the lacrimal duct intubation, open after surgery, epiphora is not obvious, but in outpatient treatment, economic benefits suitable for primary hospitals. 　　Key words: lower lacrimal laceration; anastomosis of lacrimal duct; silicone tube 　　 　　 　　泪小管断裂是眼科急诊中的常见病，以下泪小管断裂多见。一般认为下泪小管引流泪液的功能约占75%[1]，若不及时正确地进行泪小管断端吻合，不仅造成终身溢泪，而且影响美观。我科2009年3月～2013年6月共收治40例下泪小管断裂患者，采用山东福瑞达公司生产的带球形端探针的硅胶管（见附图），行单泪道外环路硅胶管插入泪小管吻合术，经济实用且效果好，现介绍如下。 　　1 资料与方法 　　1.1一般资料 收集我院自2009年3月～2013年6月住院和门诊手术治疗的下泪小管断裂患者共40例（40只眼），年龄4～61岁，男36例，女4例，受伤时间1h～2d，均行一期泪小管吻合手术。 　　1.2方法 ①0.5%地卡因表面麻醉结膜囊，棉签蘸2%地卡因加少许肾上腺素混合液表面麻醉伤侧下鼻道黏膜，并收缩下鼻甲；②常规