先天性鼻泪管阻塞的综合治疗

Integrating treatment in patients with congenital nasolacrimal duct obstruction

目的 先天性鼻泪管阻塞是婴幼儿常见的眼病 ,其处理历来存在争议。本文的研究目的是探讨应用滴抗菌素眼液加泪囊挤压按摩、泪道加压冲洗及鼻泪管探通术的综合治疗方法对先天性鼻泪管阻塞患儿的临床应用价值及其治疗效果。方法我们回顾性分析了 4 83例 54 7眼 ,从 1997年 1月～ 2 0 0 0年 12月在中山眼科中心小儿眼科门诊治疗的先天性鼻泪管阻塞的病例资料 ,首诊平均年龄为 11.8个月。根据患者的年龄和症状 ,分别采用滴抗菌素眼液加泪囊挤压按摩 ,泪道加压冲洗及鼻泪管探通的综合治疗方法进行处理 ,并观察随访 3个月以上 ,症状消失作为治愈的指标。结果 综合治疗方法对先天性鼻泪管阻塞总的治愈率为 97.3 % .其中 6.1%病例用滴抗菌素眼液加泪囊挤压按摩法治愈 ;8.2 %病例用泪道加压冲洗法治愈 ;83 %的病例用鼻泪管探通术治愈。共有 15例患儿在治疗中发生并发症。结论 综合治疗方法对先天性鼻泪管阻塞患儿是安全有效的处理方法。

Objective The purpose of this study was to determine the success rate of integrating therapy with antibiotic drops and nasolacrimal sac massage, irrigated under high pressure, and nasolacrimal duct probing for congenital nasolacrimal duct obstruction.Methods We have retrospectively evaluated 483 subjects 547 eyes treated from January 1997 to December 2000 at Pediatric Clinic of Zhongshan Ophthalmic Center. The mean age of first examination was 11.8 months. According to symptoms and age, patients were treated with antibiotic drops and nasolacrimal sac massage, irrigation under high pressure and nasolacrimal duct probing. Recovery was confirmed only after a 3-month symptom-free period. Results The overall success rate was 97.3% . 6.1% of patients recovered with topical antibiotic therapy, 8.2% of patients recovered with irrigation under high pressure and 83% with nasolacrimal duct probing. Complications of the treatment in CNLD obstruction occurred in 15 patients. Conclusion The integrating therapy is a safe and effective therapeutic technique for the treatment of infants with congenital nasolacrimal duct obstruction.