先天性鼻泪管阻塞泪道探通最佳时机的探讨

目的评估先天性鼻泪管阻塞最佳手术探通时机。方法随机选择眼科门诊2009年1月至2010年9月1057例(1232只眼)先天性鼻泪管阻塞病例。根据年龄分为A组(<1个月),B组(1～3个月),C组(3～6个月),D组(≥6个月)4组进行观察,所有患儿均在局麻下采用泪道冲洗探通针一次性完成泪道探通手术,手术前后使用生理盐水行泪道冲洗1～2 d,术后予妥布霉素滴眼液滴眼,对于术后泪道不通患儿手术1周复行泪道再次探通,2次探通失败者手术后1个月后再行泪道探通术。治愈标准为无溢泪,无分泌物,泪道冲洗通畅。术后仍然流泪,伴分泌物,泪道冲洗不畅为无效。结果 A组、B组、C组、D组1次治愈率分别为100%、93.3%、82.6%、66.7%,4组比较,患儿年龄越小,手术探通治愈率越高,差异有统计学意义(P<0.01)。结论先天性鼻泪管阻塞,年龄越小手术治愈率越高,出生后3个月内为最佳探通治疗时机。

Evaluotion of lacrimal passage probing in congenital nasolacrimal duct-block

Objective To investigate the chance on the treatment of infantile nasolacrimal duct-block.Methods Between 2009 and 2010,there were 1232 congenital dacyrocystitis cases treated with lacirmal passage probing,All the cases were grouped in four categoires：A group（1 months）2,B group（1~3 months）,C group（3~5 months）,D group（≥6 months）.Probing and irrigation were performed in local anesthesia.Probing had been pefrormed second time after one week and the third time probing followed one month later.Successful cases were deifned with absence of symptoms and signs like tearing,crusting,and discharge regurgitation with pressure on the lacirmal sac.Result The curative rate of A group,B group,C group,D group was seperately 100%,93.3%,82.6%,66.7%.Compared four group,the age were low,the cure rate were high,the difference had statistical significance（P〈0.01）.Conclusion The age were low,the cure rate were high,and the best chance of treatment of infantile nasolacrimal duct-block was the infancy aged in 3 months.