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内眦角处皮肤薄嫩、皮下组织疏松,外伤时容易导致内眦皮肤挫裂伤。而内眦裂伤常合并泪器损伤,其中最常见的是泪小管断裂。泪小管断裂是眼科常见急症,手术是修复的唯一方法[1]。但若处理不当常会造成眼睑畸形和泪溢等症状,影响病人工作及生活。手术的关键点是寻找泪小管断端,并置入合适的泪道支撑物[2]。既往常用于临床的泪道支撑物有硬膜外导管、硅胶泪道引流管等[3]。近年来,随着材料以及制作工艺的进步,RS泪道引流管逐步应用于临床[4]。我科应用其修复泪小管损伤,并取得良好效果。现作报道。
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观察组病人手术时间为(45.17±5.80)min,对照组为(57.07±5.09)min,观察组显著短于对照组(t=6.66,P<0.01)。
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术后并发症主要有鼻出血、置管脱落、眼睑畸形(睑内翻或睑外翻)、泪点撕裂等。2组病人术后并发症总发生率差异有统计学意义(P<0.05)(见表 1)。
分组 n 鼻出血 眼睑畸形 置管脱落 泪点撕裂 总并发症/% P 观察组 23 1 0 0 1 8.70 对照组 15 0 1 2 3 40.00 <0.05△ 合计 38 1 1 2 4 21.05 △示Fisher确切概率 表 1 2组病人术后并发症比较(n)
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拔管后随访3个月,观察组与对照组术后效果差异无统计学意义(P>0.05)(见表 2)。
分组 n 治愈 好转 无效 总有效/% uc P 观察组 23 12 10 1 95.65 对照组 15 7 5 3 80.00 0.73 >0.05 合计 38 19 15 4 89.47 表 2 2组病人疗效比较(n)
RS泪道引流管与单腔硅胶泪道引流管在泪小管损伤修复中的应用比较
Comparison of the application value between RS-type lacrimal duct drainage tube and single chamber silicone lacrimal duct drainage tube in the repair of lacrimal canalicular rupture
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摘要:
目的探讨RS泪道引流管与单腔硅胶泪道引流管在泪小管损伤修复中的临床疗效。 方法选择下泪小管断裂病人38例,按泪道支撑物种类不同分为观察组和对照组。观察组泪道支撑物为RS泪道引流管,对照组泪道支撑物为单腔硅胶泪道引流管。对比2组病人手术时间、术后并发症、临床疗效差异。 结果观察组病人手术时间为(45.17±5.80)min,显著短于对照组的(57.07±5.09)min(P < 0.01)。观察组病人术后鼻出血1例,泪点撕裂1例;对照组病人出现眼睑外翻1例,置管脱落2例,泪点撕裂3例;2组病人术后并发症总发生率对比差异有统计学意义(P < 0.05)。拔管后随访3个月,2组病人术后效果差异无统计学意义(P>0.05)。 结论RS泪道引流管对于泪小管损伤修复有良好的手术效果,与单腔硅胶泪道引流管相比,手术时间更短,术后并发症更少,值得临床推广应用。 Abstract:ObjectiveTo compare the clinical outcomes between RS-type lacrimal duct drainage tube and single chamber silicone lacrimal duct drainage tube in the repair of lacrimal canalicular rupture. MethodsThirty-eight patients with lacrimal canalicular rupture were divided into the observation group and control group according to the types of lacrimal duct support.The lacrimal duct supports in the observation group and control group were RS-type lacrimal tube and single chamber silicone lacrimal drainage tube, respectively.The operation time, postoperative complications and clinical effect between two groups were compared. ResultsThe operation time in observation group[(45.17±5.80) min] was significantly lower than that in control group[(57.07±5.09) min] (P < 0.01).One case with postoperative nosebleed and 1 case with lacrimal tear were identified in the observation group, and 1 case with eyelid valgus, 2 cases with catheterization and 3 cases with lacrimal tear were identified in the control group.There was statistical significance in the total incidence of postoperative complications between two groups (P < 0.05).After 3 months of extubation, the difference of the postoperative effect between two groups was not statistically significant (P>0.05). ConclusionsThe effect of RS-type lacrimal tube in the repair of lacrimal canaliculus injury is good, and the operation time and postoperative complications of which are shorter and less compared with the single chamber silicone lacrimal duct drainage tube.It is worthy of clinical application. -
Key words:
- lacrimal canalicular rupture /
- repair /
- lacrimal duct drainage tube
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表 1 2组病人术后并发症比较(n)
分组 n 鼻出血 眼睑畸形 置管脱落 泪点撕裂 总并发症/% P 观察组 23 1 0 0 1 8.70 对照组 15 0 1 2 3 40.00 <0.05△ 合计 38 1 1 2 4 21.05 △示Fisher确切概率 表 2 2组病人疗效比较(n)
分组 n 治愈 好转 无效 总有效/% uc P 观察组 23 12 10 1 95.65 对照组 15 7 5 3 80.00 0.73 >0.05 合计 38 19 15 4 89.47 -
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