先天性泪囊膨出诊断和治疗及病因探讨

目的：回顾性研究我院接诊的先天性泪囊膨出患者,并讨论该类疾病产生的病因和临床处理方案。方法：系统回顾我院2002-01-01/2011-12-31就诊的先天性泪囊膨出患儿共9例10眼,其中男4例4眼,女5例6眼,均在出生后立即发现泪囊区肿块,对所有患者进行全身抗生素使用和局部泪囊冲洗注入抗生素。结果：对经空心泪道探针抽取泪囊内脓液的7眼进行细菌培养,病菌检出率为90%。检出分别是G-菌3株,G＋菌6株。G-菌对左氧氟沙星、环丙沙星最为敏感,G＋菌对左氧氟沙星和妥布霉素最为敏感。细菌对红霉素的敏感性均最低。2眼在以上治疗后采用泪道探通术。结论：先天性泪囊膨出有典型的临床表现,新生儿科及眼科医生可早期发现,多合并胎儿先天性泪道阻塞,多转归成急性泪囊炎,出生后应积极治疗避免并发症出现。

Diagnosis, management and etiology of congenital dacryocystocele

AIM: To retrospectively study infants with congenital dacryocystocele, discuss the cause of such diseases and treatment.

METHODS: We performed a retrospective chart review of all patients presenting with dacryocystoceles to our hospital between the years of 2002 and 2011.

RESULTS: Nine patients 10 eyes were identified(4 male, 5 female), presenting at a median age of 7 days of life. All patients presented with cellulitis or dacryocystitis, and required systemic and local antibiotics. Bacteria were detected in 90% in the lacrimal sac. 3 cases of G^-bacteria, which sensitive to levofloxacin, ciprofloxacin, and 6 cases of G ⁺ bacteria which sensitive to levofloxacin and tobramycin. Minimum sensitivity of bacteria to erythromycin. Two eyes required probing in the operating room.

CONCLUSION: Congenital dacryocystoceles with typical clinical manifestations can be early detected by neonatology and ophthalmologist, many with congenital lacrimal duct obstruction and become infected, which require systemic antibiotic treatment. Referral in the early neonatal period can aid intervention in time before complications such as infection occur.