麻醉方式对新生儿泪道探通治疗效果的影响  

Effect of anaesthesia on the therapeutic effect of lacrimal passage probing in neonates

作　　者：施节亮 涂云海 姜文浩 金约西 吴文灿 SHI Jieliang;TU Yunhai;JIANG Wenhao;JIN Yuexi;WU Wencan(Department of Ophthalmology,Eye Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属眼视光医院眼科,温州325000

出　　处：《中国眼耳鼻喉科杂志》2021年第4期272-275,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：温州市科技计划项目(Y20170801)。

摘　　要：目的探讨七氟醚吸入性全身麻醉下和盐酸丙美卡因表面麻醉下行泪道探通治疗新生儿先天性鼻泪管阻塞(CNLDO)的疗效及其安全性。方法回顾性系列病例研究。收集2017年1月1日~2019年12月31日在本院行泪道探通术治疗的472例(635眼) CNLDO患儿临床资料,患儿年龄为6~12个月,平均9个月,随访时间为6~12个月。治疗成功定义为结膜囊无分泌物、无流泪等症状,荧光染料消失试验(FDDT) 0级或l级,泪道冲洗通畅。根据不同的麻醉方式分为七氟醚吸入性全身麻醉组和盐酸丙美卡因表面麻醉组,分析不同麻醉方式对患儿治愈率的影响,并对术中假道形成、出血等并发症进行总结。结果采用χ^(2)检验进行统计学分析。结果七氟醚吸入性全身麻醉组纳入383眼,治愈率为95.82%(368/383);盐酸丙美卡因表面麻醉组纳入252眼,治愈率为89.68%(226/252),二者差异有统计学意义(χ^(2)=10.31,P<0.05)。此外,全身麻醉组术后有5眼(5/383,1.3%)出现并发症,而表面麻醉组术后有13眼(13/252,5.2%)出现并发症,二者差异有统计学意义(χ^(2)=8.193,P<0.05)。结论对于CNLDO,全身麻醉行泪道探通术比在表面麻醉下行泪道探通术成功率更高,在手术医师操作的便利性以及手术的安全性方面,全身麻醉下行泪道探通术更具优势。Objective To evaluate the efficacy and safety of probing under inhalation anesthesia and surface anesthesia for congenital nasolacrimal duct obstruction(CNLDO). Methods Retrospective noncomparative case series. Clinical data were collected on 472 cases(635 eyes) with congenital nasolacrimal duct obstruction who had undergone probing at the Eye Hospital of Wenzhou Medical University between January 1, 2017 and December 31, 2019, aged from 6 to 12 months with an average at 9 months. The follow-up period varied from 6 to 12 months. Successful treatment was defined as no secretion from the conjunctival sac, no tearing and other symptoms, fluorescent dye elimination test(FDDT) grade 0 or 1, patency of lacrimal passage irrigation. The children were divided into two groups: sevoflurane inhalation general anesthesia group and surface anesthesia group, according to different anesthesia methods. The effects of different anesthesia methods on the cure rate of patients were analyzed, and the introoperative complications such as the false passage laterally and bleeding were summarized. χ^(2) test was used for statistical analysis. Results Sevoflurane inhalation anesthesia group included 383 eyes, the cure rate was 95.82%(368/383). The surface anesthesia group included 252 eyes, and the cure rate was 89.68%(226/252). The difference was statistically significant(χ^(2)=10.31, P<0.05). In addition, complications occurred in 5 eyes(5/383, 1.3%) in the general anesthesia group and 13 eyes(13/252, 5.2%) in the surface anesthesia group, with astatistically significant difference(χ^(2)=8.193, P<0.05) Conclusions For CNLDO, probing under general anesthesia has a higher success rate than that under surface anesthesia. In terms of the convenience and the safety of operation, the descending lacrimal duct probing under general anesthesia has more advantages.

关 键 词：七氟醚 泪道探通 先天性鼻泪管阻塞 

分 类 号：R726.1[医药卫生—儿科]