CAJ | 학술논문

目的：探讨在下睑纵形裂伤合并下泪小管断裂伤中，泪小管断裂鼻侧断端寻找方法的临床应用以及采用“Z”形皮瓣修复下睑纵形裂伤的效果。 　　方法：我科2010-09/2013-10收治下睑纵形裂伤合并下泪小管断裂患者37例37眼行泪小管断端吻合及下睑裂伤缝合术，术中综合运用直视法、探针插入指引法及猪尾巴弯探针法寻找到泪小管鼻侧断端，置入硅胶管作为泪道支撑物，并采用“Z”形皮瓣修复下睑纵形裂伤，随访3 mo~2 a。 　　结果：患者37例均能顺利寻找到泪小管鼻侧断端；泪道通畅31例(83.8%)，好转5例(13.5%)，无效1例(2.7%)，总有效率97.3%；眼睑修复良好，瘢痕细小，眼睑外观、功能基本正常。 　　结论：术中综合运用直视法、探针插入指引法及猪尾巴弯探针法均能顺利找到鼻侧断端；选用硅胶管作为泪道支撑物效果良好；“Z”形皮瓣修复下睑纵形裂伤对眼睑形态、功能的恢复效果满意。
목적：탐토재하검종형렬상합병하루소관단렬상중，루소관단렬비측단단심조방법적림상응용이급채용“Z”형피판수복하검종형렬상적효과。 　　방법：아과2010-09/2013-10수치하검종형렬상합병하루소관단렬환자37례37안행루소관단단문합급하검렬상봉합술，술중종합운용직시법、탐침삽입지인법급저미파만탐침법심조도루소관비측단단，치입규효관작위루도지탱물，병채용“Z”형피판수복하검종형렬상，수방3 mo~2 a。 　　결과：환자37례균능순리심조도루소관비측단단；루도통창31례(83.8%)，호전5례(13.5%)，무효1례(2.7%)，총유효솔97.3%；안검수복량호，반흔세소，안검외관、공능기본정상。 　　결론：술중종합운용직시법、탐침삽입지인법급저미파만탐침법균능순리조도비측단단；선용규효관작위루도지탱물효과량호；“Z”형피판수복하검종형렬상대안검형태、공능적회복효과만의。
AIM: To discuss the clinical applications of methods to localize nasal cut ends and the effects of Z-plasty in the surgeries for lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption. METHODS: From September, 2010 to October, 2013, a total of 37 patients ( 37 eyes ) with lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption were operated for anastomosis of lacrimal canaliculi disruption and suture of lower eyelid longitudinal. Different methods to search for the nasal cut ends of lacerated lacrimal canaliculi, such as “under a microscope directly”, “guided by probing needle” and“pigtail curved probe”. Then, to repair lower eyelid longitudinal laceration with Z-plasty transposition flaps. Follow up was 3mo~2a after operation. RESULTS: All nasal cut ends could be found successfully on 37 patients;Lacrimal duct unobstructed in 31 patients (83. 8%), improved in 5 patients (13. 5%), invalid in 1 patient (2. 7%),the overall successful rate was 97. 3%; the eyelids repair was satisfactory, small scars, the appearance and function was normal. CONCLUSION: The nasal cut ends can be found successfully by “directly under a microscope”, “guided by probing needle” and“pigtail curved probe”;the effect of silicone drainage tube used as lacrimal canaliculi bracket is satisfactory; most patients gained excellent recovery for both appearance and function after Z-plasty.