改良式泪道插管系统治疗儿童难治性泪道阻塞临床分析  

Clinical analysis of the modified lacrimal duct intubation system in treatment of children with refractory lacrimal duct obstruction

作　　者：韩立坡[1] 张瑜[1] 王凤仙[1] 陈会宁[1] 王素梅[1] 

机构地区：[1]河北省保定市儿童医院眼科,河北保定071051

出　　处：《河北医科大学学报》2016年第2期171-174,共4页Journal of Hebei Medical University

摘　　要：目的观察线锯式泪道扩张联合泪道插管手术治疗儿童难治性泪道阻塞的效果,并分析儿童难治性泪道阻塞治愈率的相关影响因素。方法收集保定市儿童医院眼科进行线锯式泪道扩张联合泪道插管手术治疗难治性泪道阻塞患儿306例（426只眼）,中位数年龄1.5岁,随访3~18个月。分析患儿年龄、术前治疗手段对患儿治愈率的影响。采用Pearson相关分析进行统计学处理。结果 306例（426只眼）中386只眼达到治愈标准,总治愈率为90.6%（386/426）。年龄因素：在6~12个月、〉12~24个月、〉24~36个月、〉36个月年龄组中,治愈率依次为96.6%（112/116）、91.3%（168/184）、86.0%（74/86）、80.0%（32/40）（r=-0.960,P=0.002）。术前治疗手段因素：曾患先天性泪道阻塞行泪道探通术后失败患儿、曾患先天性泪道阻塞行单纯泪道插管术后失败患儿的2个分组中,治愈率分别为93.6%（322/344）、78.0%（64/82）（P=0.004）。结论线锯式泪道扩张联合泪道插管手术对儿童难治性泪道阻塞治疗效果明显,具有较高的安全性,治愈率随年龄增长呈下降趋势;泪道探通失败患儿,行线锯式泪道扩张联合泪道插管治疗较单纯泪道插管治疗术后效果明显提高。Objective To study the effect of wire type lacrimal duct dilatation combined with lacrimal duct intubationoperation in treatment of children with refractory lacrimal duct obstruction,and to analysize related factors affecting the cure rate in children＇s refractory lacrimal duct obstruction.Methods In treatment of refractory lacrimal duct obstruction,306cases（426eyes）,the averaged age of 1years old,followed-up for 3-18 months were collected.Those patients were treated by saw type lacrimal duct expansion combined with lacrimal duct intubation surgery in the department of ophthalmology of Baoding children＇s hospital.Analysis the influence of patient age and preoperative treatment on cure rate.Pearson correlation coefficient was used for statistical analysis.Results In total of 306cases（426eyes）,386 eyes were fitted with criterion of cure.The total cure rate was 90.6%（386/426）.The age factor：the cure rate in 6~12 months groups,12 months to 24 months groups,24 months to 36 months groups,and more than 36 months groups,the cure rate was 96.6%（112/116）,91.3%（168/184）,86.0%（74/86）,80.0%（32/40）（r=-0.960,P=0.002）.Preoperative treatment factors：the cure rate in probing of lacrimal passage after failure of children,children with pure lacrimal duct intubation failed after 2groups were：93.6%（322/344）,78.0%（64/82）（P=0.004）.Conclusion Treatment effect in wire type lacrimal duct dilatation combined with lacrimal duct intubation operation for children with refractory lacrimal duct obstruction was obvious,and with high security.The cure rate was decreased with the increase of age.Saw type lacrimal duct dilatation combined with lacrimal duct intubation treatment significantly improved treatment effects compare to simple lacrimal intubation for postoperative effect of in children with the probing of lacrimal passage failure.

关 键 词：鼻泪管 泪器阻塞 儿童 

分 类 号：R777.22[医药卫生—眼科]