婴幼儿泪道阻塞实施泪道探通术的年龄段和并发症的关系分析  

Correlation analysis of age with complications of probing of lacrimal passage in infants and young children with lacrimal passage obstruction

作　　者：周巧珍 包燕 ZHOU Qiao-zhen;BAO Yan(Department of Ophthalmology,Qinghai Women and Children's Hospital,Xining 810000,China)

机构地区：[1]青海省妇女儿童医院眼科,810000 [2]青海省妇女儿童医院五官科,810000

出　　处：《中国实用医药》2024年第6期67-69,共3页China Practical Medicine

摘　　要：目的 分析婴幼儿泪道阻塞实施泪道探通术的年龄段和并发症的关系,探讨婴幼儿泪道探通术的合适时机。方法 回顾性分析诊断为泪道阻塞并在门诊表面麻醉下实施了泪道探通术的389例患儿(589只眼)的临床资料。记录患儿冲洗及探通术中及术后有无并发症发生,以及患儿发生的并发症类型和年龄。结果 本组实施了泪道探通术的389例患儿中发生并发症有54例,并发症发生率为13.88%。未发生窒息和吸入性肺炎等严重并发症。结论 婴幼儿泪道阻塞实施泪道探通术的并发症与年龄有关,其中5~7月龄患儿并发症较少,所以婴幼儿泪道探通术以5~7月龄进行为佳。由于小月龄患儿(≤3月龄)患儿神经系统、呼吸系统及吞咽功能没有发育完全,尤其是早产儿,对这个时期患儿尽可能采取保守治疗,因为泪道冲洗及探通时如果患儿吞咽不及时,可能发生呼吸道阻塞、吸入性肺炎,严重者可能引起患儿窒息、死亡等风险;对于大龄患儿(≥8月龄),患儿理解能力及身体素质变强壮,表面麻醉下患儿不容易制动并且更容易恐惧,行泪道冲洗时更加容易出现泪道的损伤,而且随着患儿年龄增大,泪道阻塞及粘连程度逐渐加重,泪道探通的成功率随着年龄增长逐渐下降。由于不同年龄段发生并发症的风险各不相同,在行泪道冲洗和泪道探通时要根据不同年龄段采取相应的预防措施,尽可能避免并发症的出现。Objective To analyze the correlation of age with complications of probing of lacrimal passage in infants and young children with lacrimal passage obstruction,and explore the appropriate timing of probing of lacrimal passage in infants.Methods The clinical data of 389 pediatric patients(589 eyes)diagnosed with lacrimal passage obstruction who underwent probing of lacrimal passage under topical anesthesia were retrospectively analyzed.The presence or absence of complications during and after the flushing and probing was recorded,as well as the type and age of the pediatric patients in whom the complications occurred.Results Complications occurred in 54 of 389 children who underwent probing of lacrimal passage,with a complication rate of 13.88%.No serious complications such as asphyxia and aspiration pneumonia occurred.Conclusion Complications of probing of lacrimal passage in infants and young children with lacrimal passage obstruction are related to age,in which children at 5-7 months of age have fewer complications,so probing of lacrimal passage in infants and young children is preferable to be performed at 5-7 months of age.As the neurological,respiratory and swallowing functions of young children(≤3 months of age)are not fully developed,especially in preterm infants,conservative treatment should be taken as far as possible for children in this period,because if the children do not swallow in time during lacrimal passage irrigation and probing,respiratory tract obstruction and aspiration pneumonia may occur,and the risk of asphyxia and death may be caused in severe cases.For older children(≥8 months of age),their understanding ability and physical fitness become stronger,children under surface anesthesia are less likely to brake and more prone to fear,and lacrimal passage injury is more likely to occur during lacrimal passage irrigation.Moreover,with the increase of age of children,lacrimal passage obstruction and adhesion gradually increase,and the success rate of probing of lacrimal passage gradually decre

关 键 词：婴幼儿 泪道阻塞 泪道探通术 并发症 年龄 

分 类 号：R779.6[医药卫生—眼科]