张方顺　田岩　赵军　王璐　张岩

【摘要】 目的 探讨U型泪道吻合支撑管在上、下泪管同时断裂吻合术中的临床应用效果。方法 28例

（38眼）上、下泪管同时断裂伤患者， 均采用自行研制U型泪道吻合支撑管行一期手术治疗， 观察疗效。

结果 38例患者均无感染， 术中插管顺利， 术后随访泪点均有不同程度轻微扩大， 4例下泪点及部分泪管撕裂， 受泪情况良好， 未行特殊处置。1例因术后泪管撕裂严重， 仍有溢泪， 行二期手术， 37例（97.37%）一期愈合。结论 自行研制U型泪道吻合支撑管应用于上、下泪管同时断裂伤吻合手术中， 效果良好， 降低了手术难度， 缩短了手术时间， 减轻了患者痛苦， 可在一期完成吻合手术， 且术后置管稳定性佳， 外观良好， 手术成功率高。

【关键词】 U型泪道吻合支撑管；自行研制；临床应用

DOI：10.14163/j.cnki.11-5547/r.2016.26.018

【Abstract】 Objective To investigate clinical application effect by U-shaped lacrimal duct anastomosis supporting tube in simultaneous upper and lower lacrimal duct anastomosis. Methods A total of 38 patients （38 eyes） with simultaneous upper and lower lacrimal duct rupture all received self-developed U-shaped lacrimal duct anastomosis supporting tube in one-stage operation treatment， and their curative effects were observed. Results There was no infection case among 38 patients. All patients received successful intraoperative intubation， and they had various enlarged dacryon shown by postoperative follow-up. There were 4 cases with ruptured lower dacryon， partial lacrimal duct and good tear condition， and they received no special treatment. There was 1 case with epiphora due to severe postoperative lacrimal duct rupture， and this patient received two-stage operation. There were totally 37 cases （97.37%） with one-stage healing. Conclusion Self-developed U-shaped lacrimal duct anastomosis supporting tube shows good effect in simultaneous upper and lower lacrimal duct anastomosis. This method reduces operating difficulty， shortens operation time， and relieves pain in patients. It provides successful one-stage operation， along with high postoperative intubation stability， good appearance and high success rate.

【Key words】 U-shaped lacrimal duct anastomosis supporting tube； Self-developed； Clinical application

泪道断裂伤是临床常见的急诊外伤之一， 上、下泪管同时断裂伤或伴有头面部复合伤者屡见不鲜， 一期吻合上、下泪管断端， 避免术后流泪是非常必要的， 其手术的技巧以及泪道支撑管的置入是手术成功的决定性因素。本院从1997年开始， 一直致力于泪道手术技巧及泪道置管的研究及创新， 自2005年以来， 本院在单管双圆头侧孔型泪道吻合支撑管临床应用的基础上[1]， 又不断改进研制成功了U型泪道吻合支撑管（专利号：200920177911.6）， 并应用于临床， 在泪管断端吻合术中发挥了重要作用， 收到了非常满意的疗效， 尤其是上、下泪管同时断裂的病例， 极大的缩短了手术时间， 提高了手术效率， 无明显手术并发症， 现报告如下。……