吸入麻醉下行泪道探通术治疗新生儿泪囊炎的临床观察

Clinical observation of lacrimal passage probing by inhalation anesthesia in the treatment of neonatal dacryocystitis

目的：探讨吸入麻醉下行泪道探通术治疗新生儿泪囊炎的临床应用价值。方法：选择我院2009／2011年经门诊规范保守治疗无效的新生儿泪囊炎住院患儿116例129眼，分为两组：6～12月龄组75例86眼，〉1岁组41例43眼，术前全身检查无手术禁忌，使用七氟烷作为吸入麻醉药物，在麻醉充分后常规行泪道探通术，术中泪道冲洗通畅后无需术后频繁泪道冲洗。治愈标准：无泪溢及溢脓，泪道冲洗通畅；无效：溢泪或溢脓，泪道冲洗不通。结果：6～12月龄组治愈率100％，〉1岁组治愈率98％，差异有统计学意义（P〈O．05）。结论：七氟烷吸入麻醉下行泪道探通术具有麻醉效果好、安全性高、苏醒快、手术操作损伤小、探通成功率极高等优点，具有较高临床应用价值。

AIM： To observe clinical outcomes of lacrimal passage probing in the treatment of neonatal dacryocystitis with inhalation anesthesia MEHTODS： There were 116 patients （129 eyes）, with neonatal dacryocystitis from 2009 to 2011 of no improvement under conservative treatment, and were divided into two groups： 75 patients （86 eyes） in 6 to 12- month-old group, 41 patients （43 eyes） in group at the age older than 1 year. With no surgical taboo found, sevoflurane was selected as inhalation anaesthetic. Lacrimal passage probing was operated with sufficient anaesthesia. With clear lacrimal passage washed in the operation, there was no need to wash again postoperatively. Successful cases were defined with clear lacrimal passage and absence of symptoms as epiphora and pyorrhea, while incidence of those symptoms showed treatment in vain. RESULTS： The recovery rate of 6 to 12-month-old group was 100%, while the recovery rate of group at the age older than 1 year was 97. 7% The difference was statistical significance （P〈0.05）. CONCLUSION： Lacrimal passage probing by inhalation anesthesia in use of sevoflurane is safe and effective with fast revival, small operative injury, high successful rate ofprobing, and it has great clinical application value,