鼻泪管探通术治疗先天性鼻泪管阻塞的疗效观察(英文)

Effectivity of nasolacrimal probing for the treatment of congenital nasolacrimal duct obstruction: a retrospective study

目的:研究探通术与灌溉对儿童先天性鼻泪管阻塞(congenital nasolacrimal duct obstruction,CNDO)的成功率及相关因素。方法:从2005/2011,患有CNDO的儿童235例261眼行鼻泪管探通术。患者按年龄分为3组:组1,131眼为12～24月龄;组2,82眼为24～48月龄;组3,48眼为48～120月龄。在全身麻醉下进行上、下泪小点探通术。术后1d;1、2wk;1、3mo进行随访。通过Mann Whitney U检验和卡方检验分析手术成功率与年龄的相关性。结果:儿童235例(女性122例,男性113例)的平均年龄为27.6±10.7(12～120)mo。3组患儿一次探通术后的成功率分别为90.1%、85.4%和47.6%,并且组1、组2成功率显著高于组3(P<0.05)。患儿53例(20.3%)再次行探通术,3组的成功率分别为:61.5%、58.3%和25.0%。结论:鼻泪管探通术是治疗CNDO的有效方法,特别是对于小于2岁的患儿。手术成功率随着年龄增加而降低,但是上下泪小管二次探通术可以提高术后效果。

AIM： To investigate the success rate and relevant factors for probing and irrigation in children with congenital nasolacrimal duct obstruction（CNDO）. ~ METHODS： A total of 261 eyes from 235 children were treated surgically with probing due to CNDO between 2005 and 2011. Patients were classified into three groups with respect to age. Group 1 （12-24 months）, group 2 （24-48 months） and group 3 （48-120 months） consisted of 131, 82 and 48 eyes respectively. Probing was performed for upper and lower puncture under general anesthesia. Postoperative control visits were performed on l＇t day, 1 = and 2nd weeks, 1= and 3＇d months. Success rate and correlation with age were analyzed using Mann Whitney U and Chi-square tests. ~ RESULTS： The mean age for the 235 patients （122 females, 113 males） was 27.6~10.7 （12-120） months. The rates of success after one probing in groups 1, 2 and 3 were 90.1%, 85.4% and 47.6% respectively and the procedure was significantly more successful in groups 1 and2 （P〈0.05）. Probing was repeated in 53 （20.3%） patients and rates of success in groups 1, 2 and 3 were 61.5%, 58.3% and 25.0% respectively. CONCLUSION： Probing is an effective treatment for CNDO especially in children 〈 2 years of age. Rate of success decreases with advancing age, but second probing and application both through upper and lower canaliculi are measures that may improve the outcome.