婴幼儿先天性鼻泪管阻塞的治疗探讨

目的：探讨不同年龄阶段的先天性鼻泪管阻塞的婴幼儿,在不同时期采取不同的治疗方法。 方法：将87例102眼患儿分成三个不同的年龄段组：第一组：25天龄~3月龄21例26眼；第二组：〉3~7月龄31例36眼；第三组：〉7~24月龄35例40眼。对第一组实行泪囊鼻泪管按摩＋滴眼液治疗；对第二组进行泪道加压冲洗治疗；对第三组施行鼻泪管探通术治疗。 结果：第一组患儿经泪囊鼻泪管按摩＋滴妥布霉素眼液治疗通畅者12眼,治愈率为46.2%；第二组患儿经泪道加压冲洗治疗通畅者33眼,治愈率为91.7%；第三组患儿经鼻泪管探通术治疗通畅者36眼,治愈率为90.0%。第二组和第三组效果明显优于第一组（χ2=15.71,P〈0.01；χ2=15.27,P〈0.01）；第二组和第三组治疗效果无明显差异（χ2=0.02,P〉0.05）。 结论：婴幼儿先天性鼻泪管阻塞应该区分年龄阶段,采取不同的治疗方法,才能获得较好的治疗效果,而泪道加压冲洗是治疗婴幼儿先天性鼻泪管阻塞的首选方式。

Treatment of infants with congenital nasolacrimal duct obstruction

AIM. To explore the different ages of congenital nasolacrimal duct obstruction in infants, take different treatment methods at different times. METHODS： The 87 cases of 102 children were divided into three different age groups： the first group of 25d- 3mo of age 21 cases 26 eyes; The second group 〉3mo- 7mo 31 cases 36 eyes; The third group 〉7-24mo of age 35 cases 40 eyes. For the first group of infants, the implementation of the lacrimal sac nasolacrimal duct massage ＋ eye drops; for the second group of infants, carry lacrimal pressure washing treatment; for the third group of infants, the implementation of the nasolacrimal duct probing treatment. RESULTS： The first group of children through the nasolacrimal duct sac massage ＋ drops tobramycin eye drops treatment unobstructed 12, the cure rate was 46. 2% ; The second group of children through pressurized irrigation treatment lacrimal patency by 33, the cure rate was 91. 7%; The third group of children through the nasolacrimal duct probing unobstructed 36 treatment, the cure rate was 90.0%. The second and third group were better than the first group （χ2 =15.71, P〈0.01 ;χ2 =15.27, P〈 0.01 ） ; the treatment effect of the second and third groups was no significant difference （χ2=0.02, P〉0.05）. CONCLUSION ：Infants with congenital nasolacrimal ductobstruction should distinguish different treatments, in order between ages, taking to obtain a better therapeutic effect, and lacrimal pressure washing is the preferred way of treating infants with congenital nasolacrimal duct obstruction.