泪道冲洗和泪道探通治疗3 558例先天性泪道阻塞的时机及方法探讨  

Timing and method of lacrimal duct irrigation and probing in treatment of congenital nasolacrimal duct obstruction:a retrospective study of 3558 cases

作　　者：岑超 何俐莹[1] 陶雪莹 刘娅 CEN Chao;HE Liying;TAO Xueying;LIU Ya(Department of Ophthalmology and Otolaryngology,Chongqing Health Center for Women and Children,Chongqing,400021,China)

机构地区：[1]重庆市妇幼保健院眼耳鼻喉科,重庆400021

出　　处：《第三军医大学学报》2021年第23期2590-2595,共6页Journal of Third Military Medical University

基　　金：重庆市社会事业与民生保障科技创新专项重点研发项目(cstc2017shms-zdyfX0049)。

摘　　要：目的探讨先天性泪道阻塞(congenital nasolacrimal duct obstruction,CNLDO)行泪道冲洗及泪道探通的最佳治疗时机及治疗方法。方法采用回顾性分析,选取2017年4月至2020年12月于重庆市妇幼保健院就诊的3558例(5514只眼)CNLDO患儿,共5514只眼,根据患儿性别、分娩方式、治疗月龄进行分组,比较各组间泪道冲洗成功率的差异。对723例(723只眼)行泪道探通治疗的患儿按照月龄、泪道冲洗次数进行分组,比较各组间1次性探通成功率的差异。结果泪道冲洗治疗结果显示,<2月龄患儿1次通畅率最高,为66.36%,2~4月龄、>4~6月龄和>6月龄患儿1次通畅率分别为46.25%、38.05%和28.64%,不同月龄组间差异具有统计学意义(P<0.001);泪道冲洗的通畅率与分娩方式无关(P>0.05),男性冲洗通畅率(46.38%)大于女性(39.39%)(P<0.05)。泪道探通术治疗结果也显示,患儿月龄越小、泪道冲洗次数越少,1次性探通成功率越高(P<0.01)。结论先天性泪道阻塞行泪道冲洗及泪道探通治疗的时机越早,效果越好。在多次泪道冲洗不通畅时结合泪道探通术可有效治疗先天性泪道阻塞。Objective To explore the best time and method of lacrimal duct irrigation and probing in the treatment of children with congenital nasolacrimal duct obstruction(CNLDO).Methods A total of 3558 children with CNLDO(5514 eyes)who were treated in our hospital from April 2017 to December 2020 were enrolled and retrospectively analyzed.They were divided into groups according to their gender,delivery mode and treatment age,and the success rate of lacrimal duct irrigation was compared among the corresponding groups.In addition,723 of the patients(723 eyes)who underwent lacrimal duct probing therapy were grouped according to their age and number of lacrimal duct irrigation,and the success rate of one-time patency was compared among the corresponding groups.Results In terms of lacrimal duct irrigation,the one-time patency rate was the highest in children aged<2 months(66.36%),along with 46.25%,38.05%and 28.64%in children aged 2~4 months,4~6 months and>6 months,respectively,showing significant difference in age groups(P<0.001).In addition,the patency rate of lacrimal duct irrigation was independent of the childbirth mode(P>0.05),and the patency rate of boys(46.38%)was higher than that of the girls(39.39%,P<0.05).As for the lacrimal duct probing,the treatment Results showed that the younger the children and the fewer the times of duct irrigation were,the higher the success rate of one-time patency of probing achieved(P<0.01).Conclusion Earlier lacrimal duct irrigation and probing in the treatment for CNLDO will lead to better therapeutic efficacy.CNLDO can be effectively cured by lacrimal duct probing when repeated lacrimal duct irrigation fails.

关 键 词：先天性泪道阻塞 泪道冲洗 泪道探通术 

分 类 号：R615[医药卫生—外科学] R777.22[医药卫生—临床医学]