难找断端下泪小管断裂合并鼻泪管阻塞手术方案及疗效.docVIP

难找断端下泪小管断裂合并鼻泪管阻塞手术方案及疗效 　　【摘要】 目的：对难找断端的下泪小管断裂合并鼻泪管阻塞的手术方案及疗效进行分析探讨。方法：选取2009年2月-2014年2月本院收治的50例下泪小管断裂合并鼻泪管阻塞患者，随机数字表法分为两组，每组25例。对照组给予硬膜外麻醉管断裂吻合术治疗，观察组给予双路置管断裂吻合术治疗，比较两组的治疗效果。结果：两组平均手术时间比较，差异无统计学意义；观察组平均拔管时间短于对照组，比较差异有统计学意义（P0.05）；两组临床治疗的有效率比较，差异无统计学意义；观察组并发症发生率4.0%，低于对照组28.0%，比较差异有统计学意义（P0.05）。结论：吻合口造瘘术联合双路置管断裂吻合术治疗难找断端的下泪小管断裂合并鼻泪管阻塞可有效缩短患者拔管时间，降低患者并发症的发生率，具有非常积极的临床应用价值。 　　【关键词】 鼻泪管阻塞； 下泪小管断裂； 吻合口造瘘术 　　【Abstract】 Objective： To analyze the surgery program and efficacy of inferior lacrimal duct rupture combined nasolacrimal duct obstruction with stump that hard to find. Method： 50 patients with inferior lacrimal duct rupture combined nasolacrimal duct obstruction from February 2009 to February 2014 in our hospital were selected and randomly divided into two groups， there were 25 cases in each group， the control group was treated with epidural anesthesia tube， the observation group was treated with dual tube rupture anastomosis， the curative effect were compared between the two groups. Result： The two groups mean operative time had no significant difference. The observation group mean extubation time was shorter than that of control group （P0.05）. Total effective rate of the two groups had no significant difference. The complication rate of the observation group 4.0% was lower than that of the control group 28.0% （P0.05）. Conclusion： Anastomosis fistula surgery combined with dual tube rupture anastomosis in treatment of inferior lacrimal duct rupture combined nasolacrimal duct obstruction with stump that hard to find can shorten the extubation time， reduce the complication rate of patients， and has application value very positive. 　　【Key words】 Nasolacrimal duct obstruction； Tears small tube rupture； Anastomosis fistula surgery 　　First-author’s address： Guanghua Hospital of Dongguan， Dongguan 523416， China 　　doi：10.3969/j.issn.1674-4985.2014.25.048 　　下泪小管断裂是眼科较为常见的一种撕裂伤[1]，溢泪是其主要表现之一，为患者工作、生活均带来了严重影响。部分患者下泪小管严重撕裂合并鼻泪管阻塞，断端吻合术中不易找到断端鼻侧泪小管，因而临床手术较为困难复杂，本文以50例下泪