新生儿泪囊炎泪道探通的治疗体会

Experience of probing of lacrimal passage in treatment of neonatal dacryocystitis

目的:探讨新生儿泪囊炎最佳探通时机及并发症的有效的预防。方法:收集济宁医学院附属医院眼科门诊近2年1 248例1460眼3～36个月新生儿泪囊炎病例,将接受泪道探通的患儿按年龄分为3～6个月、7～12个月、13～36个月三组进行比较分析。根据感染程度不同1～3天冲洗1次,每次冲洗前行泪囊区按摩,连续冲洗4～6次炎症控制后行泪道探通。治愈标准为无溢泪、无分泌物、泪道冲洗通畅。结果:治愈率第一组为98.96%、第二组为96.27%、第三组为89.9%,三组有显著性差异(P<0.05)。结论:泪道探通是一种比较简单、易操作、微创、患儿家属易接受的治疗方法,应作为3～36个月新生儿泪囊炎患儿治疗的首选方法,手术时机的掌握及操作者的熟练程度及手术前后合理有效的护理干预是手术成功的关键。根据并发症发生的原因做好预防工作,可使并发症的发生率降至最低点。

Objective： To investigate optimal opportunity of lacrimal duct probing in treatment of neonatal dacryocystitis and ef- fective prevention of complications, nethods：1460 eyes of 1248 patients of 3 -36 months old with neonatal dacryocystitis were treated with the probing of lacrimal passage, and received postoperative follow - ups. Three groups were designed according to the ages of the babies： 3 -6m, 7 - 12m and 13 -36m. Irrigation of lacrimal passage was carried out for 1 time/1 -3 days according to the gradient of infection. Lacrimal sac area was massaged before irrigation. The probing of lacrimal passages was carried out until the infections were cured. Cure criterion was no epiphora, no secretions, and unobstructed irrigation of lacrimal passage. Results： The cure rates of the first, second and third groups were 98.96%, 96.27% and 89.9%, and there were obvious differences among the three groups （P 〈 0.05 ）. Conclusions ： The probing of lacrimal passage is a safe and effective method for the neonatal dacryocystitis, has a minimal inva- sion, is easily accepted by the children families, and is the first choice for 3 - 36m babies. Further, operation time, operator skill, and effective perioperative nursing are the key points of the successful operation; and the incidence rates of the complications can be re- duced to the minimum if a good prevention work is made.