新型硅胶管逆行置管治疗少儿泪小管断裂的疗效分析

Clinical effect of new silicone tube retrograde catheterization in the treatment of lacrimal canaliculus rupture in children

摘要:

目的：观察新型硅胶(RS-1型)泪道引流管逆行置管治疗少儿泪小管断裂的临床效果。

方法：回顾性分析于2016-03/2019-11邯郸市眼科医院及邯郸市中心医院收治的37例37眼泪小管断裂患者的临床资料。所有患者术中逆行植入新型硅胶管，8-0可吸收缝线吻合泪小管断端，6-0可吸收缝线间断吻合“内眦韧带-眼轮匝”复合体，间断缝合肌肉、皮下组织、皮肤伤口及结膜面伤口。术后2～3mo拔管，随访6～12mo，观察泪道通畅情况及溢泪症状。

结果：泪小管断裂37眼中，临床治愈31眼(84%)，好转5眼(14%)，无效1眼(3%)，总有效率达97%。所有患者均未发生泪小点撕裂、泪小点位置异常、成角畸形等相关并发症，无效1眼(3%)为合并骨性泪小管骨折，无明显溢泪症状。

结论：新型硅胶管逆行置管具有操作简便、术后刺激轻、置管状态安全、吻合效果显著等特点，逆行置管能较好保护泪小点。

Abstract:

AIM:To observe the clinical effect of retrograde lacrimal duct drainage tube(RS-1 type)in the treatment of lacrimal canaliculus rupture in children.

METHODS: The clinical data of 37 cases(37 eyes)with lacrimal canaliculus rupture admitted to Handan Eye Hospital and Handan Central Hospital from March 2016 to November 2019 were retrospectively analyzed. New silicone tubes were retrograde implanted in all patients during the operation. 8-0 absorbable sutures were used to anastomose the broken end of the lacrimal canaliculus, 6-0 absorbable sutures were used to anastomose the “medial canthus ligament-orbicularis” complex intermittently, and muscle, subcutaneous tissue, skin wounds and conjunctival wounds were sutured intermittently. The catheter was extubated 2-3mo after operation, and the lacrimal passage patency and lacrimal ectorrhea were observed for 6-12mo.

RESULTS: Totally 31 eyes(84%)were cured, 5 eyes(14%)were improved, and 1 eyes(3%)was ineffective. The total effective rate reached 97%. None of the patients had lacrimal dot tearing, abnormal location of lacrimal dot, angulation deformity and other related complications, and 1 invalid eyes(3%)was combined with bone lacrimal tubule fracture, without obvious lacrimal ectorsion symptoms.

CONCLUSION: The new type of silicone tube combined with retrograde catheterization has the characteristics of simple operation, light postoperative stimulation, safe catheterization state and significant anastomosis effect. The retrograde catheterization can better protect the small lacrimal spots.