新生儿泪囊炎的综合治疗效果分析  

Combination Treatment of Neonatal Dacryocystitis

作　　者：林媚[1] 张至菲[2] 林燕婷[1] 

机构地区：[1]广东省江门市妇幼保健院眼科,529000 [2]美国密歇根韦恩州立大学医学院解剖与细胞生物系,48201

出　　处：《中华眼科医学杂志（电子版）》2015年第4期24-27,共4页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

摘　　要：目的评估新生儿泪囊炎的治疗效果。方法收集2012年1月至2013年12月广东省江门市妇幼保健院眼科收治的186例（258只眼）泪囊炎新生儿的临床资料。采用妥布霉素滴眼液滴眼、泪囊区按摩、泪道冲洗及泪道探通术进行综合治疗。其中月龄4个月及以下的患儿,首诊采用妥布霉素滴眼液滴眼,并行泪囊区按摩进行治疗。若治疗时间〉4~6周仍无效果,则行泪道冲洗进行治疗。患儿月龄〉4个月的患儿经上述治疗无效者,则行泪道探通术进行治疗。泪囊按摩、泪道冲洗和泪道探通术3种方法的治愈情况以百分率的形式表示,并采用χ2检验的方法进行比较。结果所有新生儿经单纯滴眼液滴眼及泪囊按摩治愈者58例（71只眼）,占27.52%。经泪囊按摩未治愈的患儿再经泪道冲洗治疗后治愈者98例（117只眼）,占62.57%。泪囊按摩及泪道冲洗治疗后仍未治愈的患儿行泪道探通术治疗,治愈者60例（67只眼）,占95.71%。泪道探通术的治疗效果优于泪囊按摩及泪道冲洗,差异有统计学意义（χ2=122.45,P〈0.05）。泪道探通术的治疗效果分别与泪囊按摩及泪道冲洗比较,差异有统计学意义（χ2=105.07,27.52;P〈0.05）。泪道冲洗的治疗效果与泪囊按摩相比,差异有统计学意义（χ2=54.58,P〈0.05）。泪道冲洗的治疗效果与泪囊按摩相比,差异有统计学意义（χ2=54.58,P〈0.05）。泪道探通术中出现眼睑皮下水肿者1例（2只眼）,占2.86%;出现泪小管损伤、出血者2例（3只眼）,占4.29%。随访3~12个月所有患儿均未复发。结论抗生素滴眼液滴眼、泪囊区按摩或联合泪道冲洗及泪道探通术均是治疗新生儿泪囊炎的有效方法。从上泪小管进行泪道探通术操作方便、安全,值得推广。Objective To evaluate the efficacy of combination treatment for neonatal dacryosystitis.Methods A total of 186 neonatal patients（ 258 eyes） who were seeking care in the Department of Ophthalmology,Jiangmen Women and Children＇s Healthcare Institute between January,2012 and December,2013 were recruited. Patients ≤ 4 months underwent topical tobramycin therapy and nasolacrimal sac massage initially and nasolacrimal duct irrigation subsequently if the initial treatments showed no effect after4-6 weeks. Those 4 months underwent nasolacrimal duct probing if the initial treatments failed to show any significant effect. Outcome data were analyzed by chi-square test. Results The combination treatment with topical tobramycin and nasolacrimal sac massage resulted in complete healing in58（ 27. 52%） patients（ 71 eyes）. Of those who failed to respond to nasolacrimal sac massage therapy,98（ 62. 57%） achieved complete healing after lacrimal duct irrigation. Of those who failed to benefit from lacrimal duct irrigation,60（ 95. 71%） healed completely after lacrimal duct probing. Lacrimal duct probing is more effective than lacrimal sac massage and lacrimal duct irrigation（ χ2= 105. 07,27. 52; P〈0. 05）. Lacrimal duct irrigation was more effective than lacrimal sac massage（ χ2= 54. 58,P〈0. 05）. Conclusion Combined therapy with topical tobramycin,nasolacrimal sac massage,lacrimal duct irrigation and probing appears an effective,simple and safe approach in treating neonatal dacryocystitis.

关 键 词：新生儿泪囊炎 综合治疗 效果 分析 

分 类 号：R777.23[医药卫生—眼科]