先天性鼻泪管阻塞与分娩方式的临床研究

Clinical study of congenital nasolacrimal duct obstruction and mode of delivery

目的研究先天性鼻泪管阻塞(CNDO)患儿的病史资料,总结本病的发病与产妇分娩方式的相关性。方法选取2007年7月-2011年7月间于唐山市妇幼保健院进行诊治最终确诊为CNDO的1 322例患儿,共1 498只眼,其中780例为男孩,542例为女孩,对这些患儿的临床资料进行分析总结。结果 CNDO的患儿中顺产的有500例,占37.82%;剖腹产的有822例患儿,占62.18%;两种生产方式进行比较,剖腹产的患儿出现CNDO的几率明显高于顺产的患儿,两种生产方式比较,差异有统计学意义(P<0.05)。对两组患儿的膜性阻塞例数进行分析,经剖腹产的患儿发病例数明显高于顺产的患儿数量,但两种生产方式的泪道狭窄数量及骨性阻塞数量比较,差异无统计学意义(P>0.05)。结论胎儿在娩出体外的过程中,经阴道分娩时受到产道的挤压,可能会使封闭的残膜破裂,变为开放状态,而且本文的研究也表明剖腹产患儿的例数明显高于顺产患儿的数量,这就说明分娩方式在一定程度上影响了CNDO的发生率,应得到临床医生的足够重视。

Objective A history of congenital nasolacrimal duct obstruction in children,statistically analyzed, to study the relationship between delivery modes are summarized in this disease. Methods in our Hospital in 2007 July -2011 year in July between the choice of diagnosis and treatment for the final diagnosis in 1322 cases of congenital nasolacrimal duct obstruction, a total of 1498 eyes, including 780 cases of boys, 542 were girls, the clinical data of these patients were analyzed and summarized. Results through the analysis of the children of the selected mode of delivery, appear birth infants with congenital nasolacrimal duct obstruction in 500 cases, accounting for 37.82%; 822 cases of cesarean section, accounting for 62.18%; compared with two production modes, caesarean section for congenital nasolacrimal duct obstruction obviously higher than the birth of children, the differences of the two kind of production mode is more significant, with statistical significance （P〈0.05）. The membrane of two groups of children with obstructive cases were analyzed, the number of children with onset cases of cesarean section was higher than that of the number of birth of children, but the two kinds of mode of production and the number of the number of bony stenosis of lacrimal passages obstruction had no obvious difference, no statistical significance （P〉0.05）. Conclusion the fetus in the process of in vitro, vaginal delivery was the birth canal extrusion, may make the residual film closed rupture, into open state, and this study also showed that the number of cases of cesarean section were significantly higher than those of children, which means delivery style to a certain extent affected the congenital nasolacrimal duct obstruction occurred, enough attention should be clinicians.