摘要
目的:总结应用钝头静脉注射针头作断裂泪小管支撑物的吻合术的简易性和优点,并介绍在术后拔除支撑针头后佐以注碘必舒眼膏于泪道中,对提高手术疗效的作用。方法:对33例(33眼)下泪小管断裂伤者,应用7～8号静脉注射针头去尖端后磨钝和消毒,将其置入断裂泪小管后行吻合术,术后2～4wk拔除支撑针头。拔除支撑针头后,冲洗泪道继注碘必舒眼膏于泪道中,每2d一次,连续4～5次。结果:33眼均手术成功,随访3mo～6a,全组病例均泪道通畅和无泪小点裂伤或外翻等并发症。结论:用硬质针头作断裂泪小管支撑物行吻合术,操作简易,并可避免鼻泪管粘膜损伤等并发症,而且必要时可重新置入泪小管;拔除支撑针头后注入含类皮质激素的碘必舒眼膏于泪道中,可抑制泪小管吻合段的炎症反应及瘢痕形成;两者合壁,使手术效果佳,而且可缩短泪小管支撑物的置留时间,减少泪小点裂伤等并发症。
AIM： To collect the facility and feasibility of anastomosis of lacrimal ducts by using syringe needles as supports for the broken lacrimal ducts, and to introduce the function of injectiing TobraDex eye ointment into the lacrimal passages in improvinge the therapeutic effects.
METHODS： A total of 33 cases （33 eyes） suffering from disconnections of lacrimal ducts were enrolled into the research. A syringe needle of size 7-8 was chosen and its sharp end was cut off and the cross section was polished until it became smooth. Then the modified needle was placed into the broken lacrimal duct after disinfection. At postoperative 3-4 weeks, the support was removed and appropriate amount of Dianbishu eye ointment was injected into the lacrimal passage, every 2 days for 4-5 times successively.
RESULTS： The operations were successful on all 33 eyes. Over a period of 3 months to 6 years the group were followed at random, of which all had fluent lacrimal passages without complications of rimous change of lacrimal outlets or eversion.
CONCLUSION： Our data show that anastomosis of lacrimal ducts by using syringe needles as supports for broken lacrimal ducts is a simple, feasible and efficient operation, by which the nasal duct narrowing can be avoided secondary to the scar due to injure to the nasal lacrimal duct mucosae. Additionally, via using steroid-containing Dianbishu eye ointment, the inflammation and scar formation of the anastomotic segment of the lacrimal duct can be eliminated. Combination of both above methods proved to produce more desirable outcomes. Moreover, the duration of the support remaining in the lacrimal duct is shortened, thus it can alleviate the complications.
出处
《国际眼科杂志》
CAS
2007年第3期872-873,共2页
International Eye Science
关键词
泪小管断裂
吻合术
支撑针头
lacrimal canalicular laceration
anastomosis
syringe needles as supports
