先天性鼻泪管阻塞患儿泪道插管拔管时间对疗效的影响  

Timing of intubation silicone tube removal of in children with congenital nasolacrimal duct obstruction

作　　者：胡曼[1] 于刚[1] 曹文红[1] 樊云葳[1] 张诚玥[1] 吴倩[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》2014年第5期339-342,共4页Ophthalmology in China

摘　　要：目的 观察研究先天性鼻泪管阻塞患儿Ritleng泪道插管手术术后最佳拔管时间,探讨不同阻塞程度拔管时间的差异。设计回顾性病例系列。研究对象2012年1月-2013年6月北京儿童医院Ritleng泪道插管手术治疗的先天性鼻泪管阻塞患儿192例（215眼）,年龄6个月～7岁。方法 根据手术记录将泪道阻塞分为2类：（1）单纯性阻塞：探通过程中鼻泪管下方有突破感者。（2）复杂性阻塞：探通有砂样感、鼻泪道远端有连续性狭窄、探针较难通过者。统计末次随访时手术治愈率（泪道冲洗通畅,结膜囊无分泌物,无流泪等症状,荧光染料消失试验0级或1级）,观察不同阻塞类型中≤2个月拔管与〉2～6个月拔管的疗效差异。主要指标手术治愈率。结果 总手术治愈率为91.6%。在141眼（65.6%）单纯性泪道阻塞中,68眼≤2个月时拔管,最终65眼（95.6%）治愈;73眼〉2个月拔管,最终71眼（97.2%）治愈,两者比较差异无统计学意义。在74眼（34.4%）复杂性阻塞患儿中,18眼≤2个月时拔管,11眼（55.6%）最终治愈;56眼〉2个月拔管,最终50眼（89.3%）治愈,两者比较差异有统计学意义。结论Ritleng泪道插管手术后对单纯性鼻泪管阻塞的患儿,留置硅管时间2个月足够,而对于复杂性阻塞患儿建议留置2个月以上或更长时间。Objective To evaluate the results and complications of silicone tube intubation for children presenting with congenital nasolacrimal duct obstruction in relation to the timing of tube removal. Design Retrospective case series study. Participants 192 patients （215 eyes） with congenital nasolacrimal duct obstruction from Beijing Children＇s Hospital, whose age ranged from 6 months to 7 years （average 18 months）, underwent silicone intubation with the Ritleng lacrimal intubation system. Methods The patients ＇ records were reviewed regarding type of obstruction of the nasolacrimal duct, procedure details, timing of tubal removal, and Complications. Main Outcome Measure The success rate in relation to duration of silicone intubation. Results The overall success rate was 91.6%. There was no difference in the success rate between cases of tube removal within （95.6%） and after 2 months （97.2%） in children with simple obstruction of nasolacrimal duct, whereas in complex obstruction group, children whose tube removed after 2 months showed a higher success rate （89.3%） than children whose tube removed within 2 months（55.6%）. Conclusion Removal of the silicone tube at 2 months is less likely to affect the final result in children with simple nasolacrimal duct obstruction. Removal of the tube after 2 months is recommended for children with complex obstruction.

关 键 词：先天性鼻泪管阻塞/外科学 泪道插管 

分 类 号：R779.6[医药卫生—眼科]