先天性泪囊突出的临床治疗分析

Congenital dacryocystocele： Clinical treatment and analysis

目的探讨先天性泪囊突出的治疗手段及时机选择。方法回顾分析2010年8月至2012年10月在保定市儿童医院就诊的23例先天性泪囊突出病例，总结先天性泪囊突出的临床表现及特征，分析先天性泪囊突出的治疗方法及时机选择。结果23例（28只眼）先天性泪囊突出患儿，男性16例（19只眼），女性7例（9只眼），平均年龄9d，其中16例（20只眼）并发泪囊炎或蜂窝组织炎；2例（3只眼）并发呼吸窘迫。通过泪囊区按摩、泪道冲洗、患眼局部应用抗生素眼水等保守方法治愈6只眼；通过行一次泪道探通术治愈13只眼；行二次泪道探通术治愈5只眼；经鼻内窥镜直视下鼻腔内囊肿破囊治愈4只眼。结论先天性泪囊突出患儿保守治疗具有一定的治愈率，对未并发感染的患儿，保守治疗大多奏效，但大部分患儿易并发感染，此类患儿仍需手术方能达到满意效果，早期手术干预治疗能很大程度预防严重感染等并发症发生。

Objective To discuss the treatment and the time of congenital dacryocystocele, through the analysis of clinical manifestations and characteristics of congenital dacryocystocele. Methods Retrospective analysis of congenital dacryocystocele 23 cases （28eyes） treated in our hospital from August 2010 to October 2012, to summarize the clinical manifestations and characteristics of congenital dacryocystocele and analyzed the treatment of congenital dacryocystocele and time choice. Results In 23 cases （28 eyes） of congenital dacryocystocele children, 16 cases of male patients （19 eyes）, 7 female children （9 eyes）, with an average age of 9 days, 16 patients （20 eyes） with dacryocystitis or cellulitis; 2 cases （3 eyes） with respiratory distress. Six eyes were cured by dacryocyst massage, irrigation of lacrimal passage, application of antibiotic eye drops and other conservative method; 13 eyes were cured by the one probing of lacrimal passages; 5 eyes were cured by the two probing of lacrimal passages; 4 eyes were cured by nasal cyst rupture capsule. Conclusions Congenital dacryocystocele has a cure rate of conservative treatment. Concurrent infections in children need operation intervention, which can achieve satisfactory recovery effect. To a large extent, early operation treatment can prevent complications.