摘要
目的 观察研究线锯式泪道扩张联合泪道插管治疗儿童难治性泪道阻塞的疗效,分析影响儿童难治性泪道阻塞治愈率的相关因素.方法 回顾性系列病例研究.收集2012年6月至2014年9月在保定市儿童医院眼科进行线锯式泪道扩张联合泪道插管手术治疗难治性泪道阻塞患儿286例（326只眼）,平均年龄20个月,随访3～18个月.分析患儿年龄、术前治疗手段、泪道阻塞情况对患儿治愈率的影响.使用Pearson相关系数计算及独立样本t检验进行统计学分析.结果 286例（326只眼）中302只眼治愈,总治愈率为92.63％ （302/326）.年龄因素：在6～12个月,12～24个月,24～36个月,大于36月年龄组中,治愈率依次为97.67％ （84/86）、94.26％ （115/122）、88.46％ （69/78）、85.00％（34/40）（R=-0.98,P=0.0025）;术前治疗手段因素（术前曾采取何种治疗方法）：先天性泪道阻塞行泪道探通术或行单纯泪道插管术失败患儿的治愈率分别为：93.94％ （248/264）、87.01％（54/62）（P =0.0026）;鼻泪管阻塞情况因素：手术中仅一次突破和两次及以上突破分组中,治愈率分别为98.08％ （102/104）、90.09％ （200/222） （P =0.0004）.结论 线锯式泪道扩张联合泪道插管手术对儿童难治性泪道阻塞疗效明显,具有较高的安全性,治愈率随年龄增长呈下降趋势;泪道探通失败患儿行线锯式泪道扩张联合泪道插管较单纯泪道插管治愈率明显提高。
Objective To study the effect of wire type lacrimal duct dilatation combined with lacrimal duct intubationoperation in treatment of children with refractory lacrimal duct obstruction, and to analyze children＇s refractory lacrimal duct obstruction related factors affecting the cure rate.Methods A retrospective case series study.From June 2012 to September 2014 saw type lacrimal duct in the Department of Ophthalmology of Baoding children＇s hospital expansion combined with lacrimal duct intubation surgery in treatment of refractory lacrimal duct obstruction in 286 cases （326 eyes）.The averages age was 20 months, and the follow-up of 3～18 months.The effect of age, preoperative treatment situation, obstruction of lacrimal passage on the cure rate was analyzed.Using the Pearson correlation coefficient was calculated and the independent samples t test for statistical analysis.Results In 286 cases （326 eyes） cured in 302 eyes.The total cure rate was 92.63% （302/ 326）.The age factor： In 6～12 months, 12 months to 24 months, 24 months to 36 months, more than 36 months of age groups, the cure rate was 97.67% （84/86）, 94.26% （115/122）, 88.46% （69/ 78）, 85.00% （34/40） （R =-0.98, P =0.0025）;Preoperative treatment factors： Probing of lacrimal passage after failure of children, children with pure lacrimal duct intubation failed after 2 groups, the cure rates were： 93.94% （248/264）, 87.01% （54/62） （P =0.0026）;Nasolacrimal duct obstruction factors： one block and more than one time blocks 2groups,the cure rates were： 98.08% （102/104）,90.09%（200/222） （P =0.0004）.Conclusions Wire type lacrimal duct dilatation combined with lacrimal duct intubation operation for children with refractory lacrimal duct obstruction treatment effect is obvious, and it is of high security.The cure rate decreased with the increase of age;the probing of lacrimal passage failure in children with significantly improve than simple lacrimalintubation for postoperative effect of saw type lacrimal duct dilatation combined with lacrimal duct intubation treatment.
出处
《中国实用眼科杂志》
2015年第9期1021-1024,共4页
Chinese Journal of Practical Ophthalmology
关键词
儿童
泪道阻塞
泪道插管
泪道扩张
鼻泪管
Children
Lacrimal duct obstruction
Lacrimal duct intubation
Lacrimal duct dilatation
Nasolacrimal duct
