先天性泪囊炎治疗中的问题

Analysis on the problems occuring in congenital dacryocystitis treatments

目的分析先天性泪囊炎冲洗和探通中出现问题的原因，总结教训，以提高治疗成功率和安全性。方法回顾500例（694眼）先天性泪囊炎冲洗和探通治疗过程中的细节，对失败的原因进行探讨，并对因此引起的投诉和纠纷进行分析。结果694眼的治愈率为99．28％。结论1个月以内的新生儿不主张探通，除非有并发症。给2—6个月婴儿探通，首选6号针头，遇阻换5号。3个月婴儿是最佳探通时机。治疗前检查器械质量，稳妥抱头，准确轻柔操作，是避免先天性泪囊炎治疗失败和意外的因素。在细菌培养结果指导下合理使用抗生素，避免小儿禁忌品种，保障用药安全。

Objective Analyzing the causes of problems occurred in lavage and probing congenital dacryocystitis and concluding the lessons to improve the success . ratio and the security for the therapy. Methods Reviewing the details collected from 500 cases with 694 ailing eyes during the process oftavage and probing congenital dacryocystitis therapy, discussing the reasons for defeated therapy and analyzing the complains and disputes caused by those failures. Results In this treatment group, the rate of success is greater than 99% ？ the failing rate is 0i72%. Possibly failures of probing is caused by excessive and repeated opreations, too thick of a probe is chosen, on children over age. probes breaking during operations, probes cracking, patients are not well anesthetized, patients are notcarefully operated on. and using Gentarnycine as the regular detergent, which is not supposed to be. Conclusion It is not suggested to probing on newlly - born babies younger than a month, unless syndromes happen, because it is hard to tighhy hold their heads during the operations, there＇s difficulty in exposing lacrimale and they could be cured on their own. When operating on babies from two to six months, it was first suggested to use number six probe, if difficulty occurs then change to number five probe. Push the probe into lacrimal ducts along its curve without overly outstretching it, so that chances of causing damages are reduced and chances to successfully probing at once are increased. When babies are 3 months old, it＇s the best time to operate probing. Please make sure that all the operating machines are checked and fixed forehead is stable before a gentle and accurate operation takes place. This is a important factor to help avoid defeats and accidents in dacryTocystitis treatment, Anitibiotic has to be properly used under the guidance of bacterial culture result. Avoid using the kinds that children can not tolerant, so that drug - use safety was secured.