Ritleng泪道插管术治疗泪道探通失败的先天性泪道阻塞  

Efficacy of Ritleng lacrimal intubation for congenital nasolacrimal duct obstruction after unsuccessful probing

作　　者：吴倩[1] 于刚[1] 全晓杰[1] 曹文红[1] 樊云葳[1] 崔燕辉[1] 张诚玥[1] 蔺琪[1] 王媛[1] 崔杰[1] 胡曼[1] 刘雯[1] 李程[1] 张燕[1] 

机构地区：[1]首都医科大学附属北京儿童医院眼科儿科学国家重点学科,100045

出　　处：《眼科》2012年第5期331-335,共5页Ophthalmology in China

摘　　要：目的评估Ritleng泪道插管术治疗泪道探通失败的先天性泪道阻塞的效果。设计回顾性病例系列。研究对象泪道探通失败的先天性泪道阻塞患儿300例(387眼)。方法采用不同的麻醉方式对泪道探通失败的先天性泪道阻塞患儿行Ritleng泪道插管手术。术后随访12～34个月。对麻醉方法、术前是否合并泪囊炎、探通次数对Ritleng插管手术效果的影响以及术后并发症进行分析。主要指标治愈人数构成比,并发症发生率。结果 300例患儿(387眼),治愈337眼,总治愈率87.08%。局部麻醉下手术290眼,治愈255眼(87.33%)。全身麻醉下手术95眼,治愈82眼(86.31%)。术前不合并泪囊炎者301眼,治愈273眼(90.70%);手术前合并急、慢性泪囊炎者86眼,治愈64眼(74.41%),两者比较差异有统计学意义(χ2=15.756,P=0.00)。经历过1次探通手术者213眼,治愈201眼(94.37%);经历过2次探通手术者108眼,治愈93眼(86.11%);经历过2次以上探通手术者66眼,治愈43眼(65.15%),三者比较差异有统计学意义(χ2=38.350,P=0.00)。术中及术后未发现严重并发症。结论 Ritleng泪道插管术成功率高且术后并发症少,可作为先天性泪道阻塞泪道探通失败后的首选治疗方式。Objective To investigate the clinical efficacy of Ritleng lacrimal intubation for congenital nasolacrimal duct obstruction after unsuccessful probing. Design Retrospective case series. Participants 300 patients（387 eyes） with congenital nasolacrimal duct obstruction who underwent unsuccessful probing. Methods Different anaesthesia methods were applied in Ritleng lacrimal intubation. Different anaesthesia methods, infection and times of probing that may influence successful rate of the surgery were analyzed retrospec- tively. Operation complications were also analyzed. The followed-up period varied from 12 to 34 months. Main Outcome Measures Patient number and percentage of cure, and the complications. Results Operation was successful in 87.08% （337/387 cases） of all the eyes. Operation under topical anesthesia was successful in 87.33% （255/290 cases） of eyes. Operation under general anesthesia was successful in 86.31% （82/95 cases） of eyes. Operation was successful in 90.70% （273/301） of eyes without dacryocystitis. Operation was successful in 74.41% （64/86） of eyes with dacryocystitis. The difference was significant （P=0.00）. Operation success rate was 94.37% （201/213）, 86.11% （93/108）, and 65.15% （43/66） in eyes that had undergone probing once, twice and more than two times respectively. Conclusion Ritleng lacrimal intubation has high cure rate and low complications, So it is the suitable operation method for congenital nasolacrimal duct obstruction after unsuccessful probing.

关 键 词：泪道阻塞 先天性 泪道插管 

分 类 号：R779.6[医药卫生—眼科]