CAJ | 학술논문

目的：评价显微镜下行泪小管部分管壁切除联合硅胶软管植入重建泪小管的手术效果。方法收集2011年1月到2013年6月我院住院的泪小管炎患者24例。在显微镜下手术：（1）距内眦睑缘约3 mm平行切开眼睑皮肤，暴露膨大脓肿的泪小管；（2）水平切开泪小管，清除泪小管内脓性分泌物、结石和肉芽组织；（3）分别从上下泪小点植入软性硅胶管经泪囊、鼻泪管一同出鼻腔；（4）切除多余扩张的水平部分泪小管前壁，用8-0可吸收缝线间断缝合残余的泪小管后壁，包绕硅胶管，重建泪小管。术后观察6个月。结果术中见泪小管膨大脓肿，像人体“胃”的结构。术后1周拆除皮肤缝线，3个月取出泪道引流管。术后6个月，22例泪道冲洗通.，占91.7％；2例泪小管再阻塞，其中1例为术后1周泪道植入管脱落。全部患者均无流脓，泪小管无红肿，泪小点开放，睑缘整齐。结论泪小管水平部分管壁切除联合硅胶软管植入，重建泪小管，恢复泪道引流功能，疗效好，是治疗泪小管炎尤其是下泪小管炎较理想的手术方法。
목적：평개현미경하행루소관부분관벽절제연합규효연관식입중건루소관적수술효과。방법수집2011년1월도2013년6월아원주원적루소관염환자24례。재현미경하수술：（1）거내자검연약3 mm평행절개안검피부，폭로팽대농종적루소관；（2）수평절개루소관，청제루소관내농성분비물、결석화육아조직；（3）분별종상하루소점식입연성규효관경루낭、비루관일동출비강；（4）절제다여확장적수평부분루소관전벽，용8-0가흡수봉선간단봉합잔여적루소관후벽，포요규효관，중건루소관。술후관찰6개월。결과술중견루소관팽대농종，상인체“위”적결구。술후1주탁제피부봉선，3개월취출루도인류관。술후6개월，22례루도충세통.，점91.7％；2례루소관재조새，기중1례위술후1주루도식입관탈락。전부환자균무류농，루소관무홍종，루소점개방，검연정제。결론루소관수평부분관벽절제연합규효연관식입，중건루소관，회복루도인류공능，료효호，시치료루소관염우기시하루소관염교이상적수술방법。
Objective To describe the treatment of canaliculitis with Canalicular hemisection combining with intu-bation under microscopy and evaluate the surgical effect .Methods Clinical records of 24 patients diagnosed with primary canaliculitis and treated at Shantou eye center , between January 2011 and June 2013, were reviewed.All patients received the same microscopy surgery:(1)A paralleling eyelid incision, 3mm below the margin, was performed to expose the bulgy canaliculus.(2)Incising the canaliculus along its full extent .The contents of canaliculus were curetted , and purulent mate-rial drained.(3)Two ends of silicone tubing are threaded via the superior and inferior puncta , through the lacrimal sac down to the nose, where they are tied.(4) The dilated canaliculus was narrowed by Hemisection and wound was sutured with 8-0 vicryl.The follow-up time was 6 months.Results During operation, abcess was revealed within the expanded stomach-like canaliculus.The suture of the skin was removed 1 week after operation and the tubing was left for 3 months. After 6 months follow-up period, 22 patients had open lacrimal drainage system on syringing (91.7%).2 patients recur-rence with canalicular obstruction .The tubing in one of the two patients fell off 1 week after operation .The purulent dis-charge and swelling eyelid were completely resolved in all the patients with open puncta .Conclusion Canalicular hemisec-tion with intubation is an effective way to treat canaliculitis and reconstruct the canaliculus , especially for inferior canalicul-itis.