CAJ | 학술논문

目的统计2008年6月至2011年9月诊治的眼睑开放性损伤合并泪小管断裂伤109例患者,归纳泪小管断裂吻合快速有效且易于掌握的方法,影响手术成功的因素.方法手术均在显微镜下进行,分为近期组(伤后1周内)和远期组(伤后1周至1年).采用沿创缘直接探查吻合法、鼠尾钩逆行法、泪小管与泪囊吻合法.结果 109例患者中,近期组88例,术后2-3个月拔出泪道留置管后冲洗通畅88例,平均观察3个月,泪道冲洗不通者2例,1例2次手术通畅,1例未做；流泪症状消除者68例,仍有流泪症状者9例,流泪症状改善者4例,7例失访.远期组21例,拔管后泪道冲洗通畅19例,泪道冲洗通而不畅者2例；1月后不通2例；19例中,泪道通畅且流泪症状消除者15例,泪道冲洗通畅但仍有流泪症状者4例.结论 “沿创缘直接探查吻合法”是近、远期泪管断裂伤修复的主要手术方法.泪小管断裂伤要力争近期修复.对远期泪管断裂伤掌握解剖要点,多种方法灵活应用.
목적 통계2008년6월지2011년9월진치적안검개방성손상합병루소관단렬상109례환자,귀납루소관단렬문합쾌속유효차역우장악적방법,영향수술성공적인소.방법 수술균재현미경하진행,분위근기조(상후1주내)화원기조(상후1주지1년).채용연창연직접탐사문합법、서미구역행법、루소관여루낭문합법.결과 109례환자중,근기조88례,술후2-3개월발출루도류치관후충세통창88례,평균관찰3개월,루도충세불통자2례,1례2차수술통창,1례미주；류루증상소제자68례,잉유류루증상자9례,류루증상개선자4례,7례실방.원기조21례,발관후루도충세통창19례,루도충세통이불창자2례；1월후불통2례；19례중,루도통창차류루증상소제자15례,루도충세통창단잉유류루증상자4례.결론 “연창연직접탐사문합법”시근、원기루관단렬상수복적주요수술방법.루소관단렬상요력쟁근기수복.대원기루관단렬상장악해부요점,다충방법령활응용.
Objective To find the method of canalicular laceration treatment that fast and easy to grasp,and factors in the success of the operation.Methods The eyelid opening injury combined with lacrimal canaliculi rupture in 109 patients from June 2008 to September 2011 were collected in this study.Patients were divided into short-term group and late group.Operations were under the microscope,including anastomosis recording margin of direct exploration,retrograde anastomosis method of rat tail hook,lacrimal duct and lacrimal sac anastomotic method.Results In each group,most patients' lacrimal duct were flushed the patency after operations.Tears symptoms were eliminated.Conclusions The anastomosis recording margin of direct exploration is the main operation method of close and long-term lacrimal canaliculi rupture.Lacrimal canalicular rupture should strive to be recent repaired.It is very necessary to control the key points of anatomy,and to use methods flexibly in the therapy of close and long-term lacrimal canaliculi rupture.