Ritleng泪道插管术在儿童泪道手术中的应用

目的 探讨Ritleng泪道插管手术治疗儿童先天性泪道阻塞的疗效与并发症.方法 回顾性系列病例研究.2006年2月至2007年3月首都医科大学附属北京儿童医院眼科对148例(187只眼)常规施行泪道探通手术无效的先天性泪道阻塞患儿采用口服水合氯醛后局部麻醉下Ritleng泪道插管手术治疗.患儿年龄范围是5～40个月.对该方法治疗流泪等症状、恢复泪道排泄功能的疗效及术中出血或水肿、术后硅胶管脱出等并发症进行分析.随访时间为术后4～17个月.结果 术后1～3 d,157只眼(84.0%)流泪症状消失.术后3或6个月,187只眼均顺利拔管.其中178只眼(95.2%)治愈,7只眼(3.7%)好转,2只眼(1.1%)无效;46例(52只眼)5个月龄的患儿行泪道插管手术1个月后泪道排泄功能全部恢复正常.术中并发症包括鼻腔少量出血9只眼,泪小管水肿者9只眼.术后8只眼(4.3%)出现硅胶管脱出.结论 Ritleng泪道插管手术是一种便捷、安全的儿童泪道手术,可用于儿童先天性泪道阻塞的早期手术治疗.

Lacrimal intubation with the Ritleng system in congenital nasolacrimal duct obstruction in children

Objective To evaluate the efficacy and complication of the Ritleng lacrimal intubation system in the treatment of congenital nasolacrimal duct obstruction.Methods In this retrospective cases series,148 patients(187 eyes)with congenital nasolacrimal duct obstruction between 2006 and 2007 from Beijing Children's Hospital,whose age ranged from 5 to 40 months(average 13 months),underwent silicone intubation with the Ritleng lacrimal intubation system.who received unsuccessful probing procedure previously.The therapeutic effect including dacryorrhea disappearance and lacrimal passages excretory function regaining was observed and the complications such as epistaxis,lacrimal duct edema or silicone tube prolapse were recorded.The follow-up period was from 4 to 17 months(average 11 months).Results Dacryorrhea disappeared in 157 eyes(84.0%)within 1-3 days after the surgery.The tubes were left in the place for 3 or 6 months.All the 187 eyes were successfully taken out of tubes.As follow-up,the overall successful rate was 95.2%(178/187).Seven eyes(3.7%)relief from symptoms and two eyes(1.1%)were ineffective.46 cases(52 eyes),whose ages were about 5 months,regained normal lacrimal passages excretory function within 1 month after surgery.Complication included epistaxis(9 eyes)and lacrimal duct edema(9 eyes).The silicone tube prolapsed in eight eyes(4.3%).Conclusions The Ritleng lacrimal intubation system is an easy,effective and nontraumatizing procedure for the treatment of congenital nasolacarimal duct obstruction.The lacrimal intubation procedure offers an early and active treatment fur congenital nasolacrimal duct obstruct patients.