泪道探针定位法联合人工泪管植入术对外伤性泪小管断裂疗效的影响因素分析

doi:10.11958/20253755

天津医药 ›› 2026, Vol. 54 ›› Issue (9): 977-981.doi: 10.11958/20253755

泪道探针定位法联合人工泪管植入术对外伤性泪小管断裂疗效的影响因素分析

魏子岳(), 戈振华^△(), 王婷婷

徐州市第一人民医院眼科（邮编 221100）

收稿日期:2025-12-19 修回日期:2026-03-16 出版日期:2026-09-15 发布日期:2026-09-14
通讯作者: ^△E-mail：Sdzzwzy@yeah.net
作者简介:魏子岳（1989），男，主治医师，主要从事泪器病、眼表疾病、白内障方面研究。E-mail：weiziyue8925@163.com

Application of lacrimal probe positioning combined with artificial lacrimal duct implantation in traumatic lacrimal canaliculus rupture and analysis of the factors affecting the surgical effect

WEI Ziyue(), GE Zhenhua^△(), WANG Tingting

Department of Ophthalmology, Xuzhou First People's Hospital, Xuzhou 221100, China

Received:2025-12-19 Revised:2026-03-16 Published:2026-09-15 Online:2026-09-14
Contact: ^△E-mail：Sdzzwzy@yeah.net

魏子岳, 戈振华, 王婷婷. 泪道探针定位法联合人工泪管植入术对外伤性泪小管断裂疗效的影响因素分析[J]. 天津医药, 2026, 54(9): 977-981.

WEI Ziyue, GE Zhenhua, WANG Tingting. Application of lacrimal probe positioning combined with artificial lacrimal duct implantation in traumatic lacrimal canaliculus rupture and analysis of the factors affecting the surgical effect[J]. Tianjin Medical Journal, 2026, 54(9): 977-981.

摘要/Abstract

摘要：

目的探讨泪道探针定位法联合人工泪管植入术对外伤性泪小管断裂的治疗效果及其影响因素。方法回顾性纳入2022年1月—2024年12月收治的141例外伤性泪小管断裂患者，另选取2025年1—8月收治的34例同病患者进行模型内部验证。所有患者均行泪道探针定位法联合人工泪管植入术，观察手术疗效和术后并发症情况。根据术后6个月随访结果将患者分为通畅组和堵塞组，分析影响手术效果的因素并构建预测模型。采用受试者工作特征（ROC）曲线评价模型的预测效能。结果 141例中96例治愈，38例好转，临床有效率为95.04%，并发症发生率为7.80%。随访6个月后通畅组108例，堵塞组33例，未见支架晚期移位、肉芽组织形成或再狭窄。与通畅组比较，堵塞组断裂位置为近端、受伤至就诊时间≥24 h、完全断裂的人数占比更高，留管时间更短（P<0.05）。多因素Logistic回归分析显示，近端断裂、完全断裂、就诊时间≥24 h是影响患者手术效果的危险因素，留管时间长是保护因素（P<0.05）。联合这些指标预测患者手术效果的ROC曲线下面积（AUC）为0.830（95%CI：0.751~0.909），敏感度为84.80%，特异度为74.10%，内部验证模型准确度为88.24%。结论泪道探针定位法联合人工泪管植入术对外伤性泪小管断裂手术效果的预测模型能够为临床医师提供个体化的手术风险分层与预后评估工具。

关键词: 泪器, 泪道探针定位法, 人工泪管植入术, 外伤性泪小管断裂, 手术效果

Abstract:

Objective To analyze the effect of probe localization of lacrimal passage combined with artificial lacrimal duct implantation in traumatic lacrimal canaliculi rupture and the factors affecting the surgical effect. Methods A total of 141 patients with traumatic lacrimal canaliculus rupture from January 2022 to December 2024 were selected. Another 34 patients with the same disease admitted from January to August 2025 were selected for internal validation of the model. All patients underwent lacrimal duct probe localization method combined with artificial lacrimal duct implantation. The surgical efficacy and postoperative complications were analyzed. According to the follow-up results at 6 months after surgery, patients were divided into the unobstructed group and the blocked group. The factors affecting the surgical effect were analyzed, and a prediction model was constructed. The predictive efficacy of the model was evaluated using the receiver operating characteristic (ROC) curve. Results Ninety-six patients were cured, 38 improved, and the clinical effective rate was 95.04%, with a complication rate of 7.80%. After 6 months of follow-up, there were 108 patients in the unobstructed group and 33 patients in the obstruction group. No long-term complications such as late displacement of the stent, formation of granulation tissue, or restenosis were observed. Compared with the unobstructed group, the blocked group had a higher incidence of proximal fracture, a longer time from injury to seeking medical treatment (≥ 24 hours), and a higher proportion of complete fractures. The indwelling tube time was shorter (P<0.05). Multivariate Logistic regression analysis showed that the fracture site being proximal, complete fracture and the time of visit being ≥ 24 hours were risk factors affecting the surgical outcome of the patients, while a longer catheter retention time was a protective factor for the surgical outcome of patients (P<0.05). The area under the curve (AUC) of the prediction model based on these indicators for predicting the surgical effect of patients was 0.830 (95%CI: 0.751-0.909), with a sensitivity of 84.80% and a specificity of 74.10%, and the internal validation model accuracy rate was 88.24%. Conclusion The prediction model of the lacrimal duct probe localization method combined with artificial lacrimal duct implantation for traumatic lacrimal canaliculus rupture constructed in this study can provide individualized surgical risk stratification and prognosis assessment tools for clinicians.

Key words: lacrimal apparatus, lacrimal passage probe positioning method, artificial lacrimal duct implantation, traumatic lacrimal canaliculus rupture, surgical effect

中图分类号:

R779.6

图/表 5

参考文献 21

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组别		n	性别（男/女）		年龄/ 岁			受伤眼侧（左/右）	创伤类型（切割/钝击）
通畅组		108	82/26		51.29±13.48			48/60	44/64
堵塞组		33	23/10		51.91±10.69			13/20	15/18
χ²或t			0.516		0.243			0.263	0.231
组别	断裂位置						断裂程度（部分/完全）			合并眼部损伤
组别	近端			中间		远端	断裂程度（部分/完全）			合并眼部损伤
通畅组	25（23.1）			55（50.9）		28（26.0）	78/30			27（25.0）
堵塞组	16（48.5）			11（33.3）		6（18.2）	17/16			7（21.2）
χ²	8.138^＊						4.931^＊			0.198
组别			受伤至就诊时间（<24 h/≥24 h）				联合内眦成形术		留管时间/月		瘢痕体质
通畅组			58/50				7（6.5）		3.15±0.51		31（28.7）
堵塞组			8/25				2（6.1）		2.69±0.43		9（27.3）
χ²或t			8.812^＊＊				0.007		4.666^＊＊		0.025

组别		n	性别（男/女）		年龄/ 岁			受伤眼侧（左/右）	创伤类型（切割/钝击）
通畅组		108	82/26		51.29±13.48			48/60	44/64
堵塞组		33	23/10		51.91±10.69			13/20	15/18
χ²或t			0.516		0.243			0.263	0.231
组别	断裂位置						断裂程度（部分/完全）			合并眼部损伤
组别	近端			中间		远端	断裂程度（部分/完全）			合并眼部损伤
通畅组	25（23.1）			55（50.9）		28（26.0）	78/30			27（25.0）
堵塞组	16（48.5）			11（33.3）		6（18.2）	17/16			7（21.2）
χ²	8.138^＊						4.931^＊			0.198
组别			受伤至就诊时间（<24 h/≥24 h）				联合内眦成形术		留管时间/月		瘢痕体质
通畅组			58/50				7（6.5）		3.15±0.51		31（28.7）
堵塞组			8/25				2（6.1）		2.69±0.43		9（27.3）
χ²或t			8.812^＊＊				0.007		4.666^＊＊		0.025

变量	β	SE	Wald χ²	P	OR（95%CI）
断裂位置	1.440	0.508	8.022	0.005	4.221（1.558~11.435）
断裂程度	1.276	0.510	6.263	0.012	3.584（1.319~9.737）
就诊时间	1.483	0.517	8.240	0.004	4.406（1.601~12.129）
留管时间	-2.064	0.520	15.754	<0.001	0.127（0.046~0.352）
常数项	2.944	1.464	4.045	0.044	18.986

变量	β	SE	Wald χ²	P	OR（95%CI）
断裂位置	1.440	0.508	8.022	0.005	4.221（1.558~11.435）
断裂程度	1.276	0.510	6.263	0.012	3.584（1.319~9.737）
就诊时间	1.483	0.517	8.240	0.004	4.406（1.601~12.129）
留管时间	-2.064	0.520	15.754	<0.001	0.127（0.046~0.352）
常数项	2.944	1.464	4.045	0.044	18.986

因素	AUC	95%CI	敏感度/%	特异度/%	截断值
断裂位置	0.627	0.513~0.740	48.50	76.90
断裂程度	0.604	0.490~0.717	48.50	72.20
就诊时间	0.647	0.544~0.751	75.80	53.70
留管时间	0.761	0.673~0.849	57.60	81.50	3.05个月
联合预测	0.830	0.751~0.909	84.80	74.10

泪道探针定位法联合人工泪管植入术对外伤性泪小管断裂疗效的影响因素分析

Application of lacrimal probe positioning combined with artificial lacrimal duct implantation in traumatic lacrimal canaliculus rupture and analysis of the factors affecting the surgical effect

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