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目的:探讨经皮肤“一针吻合法”修复泪小管断裂手术的安全性和有效性。方法:回顾性分析32例(32眼)采用“经皮肤一针吻合法”修复的泪小管断裂病例资料,下泪小管断裂29例,上泪小管断裂1例,上下泪小管同时断裂2例。手术均在手术显微镜下进行,用5-0丝线缝合,用直径为0.8mm硅胶管作为泪管支架插入吻合的泪小管,术后3mo拔除泪管支架,随访时间3～36mo。结果:32例病例中,治愈28例(88%),基本治愈3例(9%),无效1例(3%)。拔除支架管后,29例患者随访1～36(平均12)mo,3例患者失随访。所有病例眼睑伤口愈合良好,无眼睑和内眦外伤性畸形。结论:“经皮肤一针吻合法”法修复泪小管断裂,能直接吻合泪小管的两断端,伤口不长期存留缝线,避免了缝线引起的炎性肉芽肿而造成的泪小管狭窄或阻塞。这种方法简化了手术操作,减少了手术损伤,是经济、安全、有效的。
Objective: To investigate the safety and effectiveness of percutaneous “one needle anastomosis” to repair lacrimal duct rupture. Methods: Thirty-two cases (32 eyes) were retrospectively analyzed. The data of 29 cases of lacrimal canaliculi rupture, 1 case of lacrimal ductal tubule rupture and 1 case of lacrimal ductal tubule rupture at the same time example. Surgical operation under the microscope, with 5-0 silk suture, with a diameter of 0.8mm silicone tube as a lacrimal stent inserted into the anastomotic lacrimal duct, 3mo after removal of lacrimal stent, follow-up time 3 ~ 36mo. Results: In 32 cases, 28 cases were cured (88%), 3 cases were cured basically (9%) and 1 case was ineffective (3%). After removal of the stent tube, 29 patients were followed up for 1 to 36 months (mean, 12 months), and 3 patients lost follow-up. Eyelid wound healing was good in all cases without traumatic deformity of the eyelids and infants. Conclusion: The method of anastomosis of the skin with a single needle to repair the canalicular rupture can directly match the two ends of the lacrimal canaliculus. The wound does not exist for a long time to avoid the lacrimal duct caused by the inflammatory granuloma caused by the suture Narrow or obstructed. This method simplifies the operation and reduces the surgical damage, which is economical, safe and effective.