目的：分析比较泪小管断裂的部位、受伤类型对泪小管吻合手术效果的影响。

方法：回顾性分析2016-01/2017-08收治的外伤性泪小管断裂患者87例87眼，均行泪小管断裂吻合术，术中置入硅胶泪道引流管，记录术后第3、6mo时泪道冲洗结果评估手术效果，术后3mo拔除引流管。统计致伤类型、远端距和泪道冲洗成功率，分析致伤类型和远端距与成功率的关系。

结果：泪小管断裂患者中，近端组29眼(33%)，中间组41眼(47%)，远端组17眼(20%)。切割伤致泪小管断裂22眼(25%)，其中泪小管断裂位于近端组18眼、中间组2眼、远端组2眼； 钝器击打伤或撞伤致泪小管断裂65眼(75%)，其中损伤位于近端组11眼、中间组39眼、远端组15眼。术后6mo，72眼泪道冲洗通畅，其中近端组20眼，中间组36眼，远端组16眼，三组术后解剖复位成功率分别是69%、88%、94%(P=0.047)； 切割伤和钝击伤泪道冲洗通畅患者分别为19眼和53眼，解剖复位成功率分别是86%、82%(P=0.605)。

结论：切割伤易造成靠近泪小点的泪小管断裂，钝击伤易造成靠近泪囊或位于泪囊与泪小点中间部位的泪小管断裂。损伤位置靠近泪总管或泪囊的患者术后成功率较高，而钝击伤致近泪小点的泪小管断裂术后较易发生泪道狭窄或阻塞。

METHODS: A retrospective study was conducted on 87 cases(87 eyes)of traumatic canalicular laceration from January 2016 to August 2017, who were treated with silicone lacrimal drainage tube implantation. Lacrimal irrigation were performed 3mo and 6mo after surgery, and their respective operation results were evaluated. 3mo after surgery, lacrimal drainage tube were removed. Statisical analysis was proceeded on injury types, distances as well as the success rate of lacrimal passage irrigation.

RESULTS: Among the 87 cases of canalicular laceration, 29 eyes(33%)were in the PCL(proximal canalicular laceration)group, 41 eyes(47%)were in the MCL(medial canalicular laceration)group, and 17 eyes(20%)were in the DCL(distal canalicular laceration)group. There were 22 eyes(25%)of lacrimal canaliculi fracture caused by sharp instrument injury, including 18 eyes in the PCL group, 2 eyes in the MCL group and 2 eyes in the DCL group. There were 65 eyes(75%)of lacrimal canaliculi fracture caused by blunt trauma or collision, including 11 eyes in the PCL group, 39 eyes in the MCL group and 15 eyes in the DCL group. Six months after surgery, 72 eyes of lacrimal passage irrigation were successful, including 20 eyes in the PCL group, 36 eyes in the MCL group, and 16 eyes in the DCL group. The success rate of postoperative anatomic reduction in the three groups was 69%、88%、94%, respectively(P=0.047). There were 19 eyes of acute injury and 53 eyes of blunt injury with successful lacrimal duct irrigation respectively. The success rate of anatomical reduction was 86%、82%(P=0.605), respectively.

CONCLUSION: The canalicular laceration closed to lacrimal punctum is more vulnerable to cutting injury, while the canalicular laceration, which is near the lacrimal sac or between the lacrimal sac and center part of lacrimal punctum, can be more likely caused by lacerated wound. The success rate after operation is higher for patients with distal or medial canalicular laceration, and lower for those who with blunt wound location near the lacrimal punctum.