4239例先天性泪道阻塞患儿临床疗效分析  

Clinical efficacy analysis of 4239 children with congenital tear duct obstruction

作　　者：史丽英 卢跃兵 孙爽[1] 赵胜男[1] 余继锋[2] Shi Li-ying;Lu Yue-bing;Sun Shuang(Department of Ophthalmology,Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital,Zhengzhou Children's Hospital,Henan Key Laboratory of Children's Genetics and Metabolic Diseases,Zhengzhou 450018,China)

机构地区：[1]郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院,河南省儿童遗传代谢性疾病重点实验室,450018 [2]首都医科大学附属北京儿童医院,国家儿童医学中心

出　　处：《中国斜视与小儿眼科杂志》2022年第3期39-41,35,共4页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的对4239例行泪道探通手术的先天性泪道阻塞患儿临床疗效进行分析。方法选择2019年1月至2022年3月在河南省儿童医院眼科诊断为先天性泪道阻塞并行泪道探通术患儿进行研究,对其基本信息、发病率、不同月龄泪道探通手术成功率、术后常见并发症、眼部分泌物微生物学培养等结果进行统计分析。结果共计4239例患儿纳入研究,其中男性2486例(58.65%),治愈率96.74%;女性1753例(41.35%),治愈率96.35%;不同性别治愈率差异无统计学意义(χ^(2)=0.48,P>0.05)。随着月龄增加,泪道探通手术成功率逐渐减低,3~6月龄(99.37%),6~9月龄(98.71%),9~12月龄(94.72%),12~18月龄(82.47%),18~24月龄(75.81%),不同月龄手术成功率有显著性差异(χ^(2)=871.05,P<0.05)。泪道探通最常见的并发症是出血,发生率为807例(19.04%),感染21例(0.50%),假道形成102例(2.41%),泪小点撕裂73例(1.72%),眼睑水肿105例(2.48%),喉痉挛3例(0.07%)。泪道阻塞患儿眼部分泌物微生物培养发现,常见致病菌主要为肺炎链球菌735株(17.34%)、流感嗜血杆菌564株(13.31%)、金黄色葡萄球菌434株(10.24%)、卡他莫拉菌260株(6.13%)、嗜麦芽窄食单胞菌186株(4.39%),真菌65例(1.53%),真菌感染中近平滑念珠菌感染率占80%。结论早期进行泪道探通术可安全有效治疗先天性泪道阻塞。Objective To summarize and analyze the clinical treatment of 4239 children with congenital lacrimal duct obstruction who underwent lacrimal duct probing.Methods Children diagnosed with congenital lacrimal duct obstruction and lacrimal duct probing were selected from January 2019 to March 2022 in the ophthalmology clinic of Henan Provincial Children’s Hospital.The surgical success rate,common postoperative complications,and microbiological culture of ocular secretions were statistically analyzed.Results A total of 4239 children were included in the study,including 2486 males(58.65%),with a cure rate of 96.74%,and 1753 females(41.35%),with a cure rate of 96.35%.There was no significant difference in the cure rate between genders(χ^(2)=0.48,P>0.05).With the increase of months,the success rate of lacrimal duct probing operation gradually decreased,3~6 months(99.37%),6~9 months(98.71%),9~12 months(94.72%),12~18 months(82.47%)and 18~24 months(75.81%).There were significant differences in the clinical statistics of the success rate of lacrimal duct probing in children aged(χ^(2)=871.05,P<0.05).The common complication was hemorrhage,which occurred in 807 cases(19.04%),infection in 21 cases(0.50%),false tract formation in 102 cases(2.41%),punctum tear in 73 cases(1.72%),and eyelid edema in 105 cases(2.48%),3 cases(0.07%)of laryngospasm.The microbial culture of ocular secretions of children with lacrimal duct obstruction found that the common pathogenic bacteria were mainly Streptococcus pneumoniae 735(17.34%),Haemophilus influenzae 564(13.31%),Staphylococcus aureus 434(10.24%),260 strains(6.13%)of Moraxella catarrhalis,186 strains(4.39%)of Stenotrophomonas maltophilia,and 65 cases(1.53%)of fungi,among which Candida parapsilosis accounted for 80%.Conclusion Early lacrimal duct probing can safely and effectively treat congenital lacrimal duct obstruction.

关 键 词：先天性泪道阻塞 泪道探通术 新生儿泪囊炎 微生物培养 

分 类 号：R779.6[医药卫生—眼科]