双泪道环形置管在泪小管断裂吻合术中的应用效果

Results of Application of Double Lacrimal Duct Annular Catheterization in the Anastomosis of Lacrimal Canaliculus

摘要: 目的：观察显微镜下泪小管断裂修复术中应用双泪道环形硅胶引流管作为支撑物的术后6个月疗效。方法：回顾性分析2018年9月至2020年9月于青岛大学附属青岛市市立医院就诊的下泪小管断裂患者36例(36眼)，在显微镜下寻找泪小管断端，置入环形管作为支撑物，术后3个月拔管，观察患者术后6个月的泪道冲洗及并发症情况。结果：所有患者均在显微镜下成功找到泪小管鼻侧断端并环形置管，术后第6个月复诊，34例(94.4%)患者伤口均一期愈合，泪道再通，随访期间无泪道阻塞发生。1例(2.8%)患者拔管后发生泪点部分撕裂，仍有部分泪液引流功能，未行手术治疗。1例(2.8%)患者因瘢痕收缩发生下睑外翻，溢泪症状明显，术后6月行下睑外翻矫正术，术后症状好转，但仍有轻度溢泪。结论：双泪道环形置管术后眼部刺激症状小，置管隐匿，稳定性好不易脱落，是治疗泪小管断裂的有效手术方式。

Abstract: Objective: To observe the 6-month results of double lacrimal duct annular catheterization in anastomosis of lacrimal canaliculi laceration. Methods: 36 cases (36 eyes) with inferior lacrimal canalicular laceration who were treated with double lacrimal duct annular catheterization were retrospectively analyzed in Qingdao Municipal Hospital affiliated to Qingdao University from September 2018 to September 2020. The nasal broken end of lacerated lacrimal canaliculi was found under the microscope and the circular tube was implanted as support. The tube was removed 3 months after the surgery, and the patients were followed up for 6 months. The lacrimal canal patency and postoperative complications were observed. Results: All the patients were catheterized successfully, the lacrimal passage was re-opened in 34 cases (94.4%), and no lacrimal passage obstruction occurred during the follow-up. One patient’s lacrimal puncta (2.8%) was partially tore of after extubation, but still had remaining drainage function, and did not underwent further surgical treatment. One patient (2.8%) had epiphora with cicatricial ectropion of lower eyelid. Epiphora relieved after lower eyelid ectropion correction at 6 months postoperatively. Conclusion: Double lacrimal duct annular catheterization has little irritation, concealed appearance, and good stability after surgery. It is an effective treatment for the lacrimal canaliculi laceration.