连续泪道探通术联合冲洗治疗婴幼儿泪囊炎的临床疗效观察

Clinical efficacy of continuous probing of lacrimal duct combined with lacrimal irrigation to treat infant dacryocystitis

目的比较连续重复泪道探通术联合冲洗与传统的单次泪道探通术及冲洗治疗婴幼儿泪囊炎的疗效差异。方法选择268例泪囊炎患儿,共296眼,按患儿就诊顺序分为观察组和对照组,每组各134例,其中观察组144眼,对照组152眼。观察组采用重复泪道探通术联合冲洗治疗,对照组仅采用单次泪道探通术及冲洗治疗。术后对两组患儿的综合疗效进行评价,并比较两组患儿的并发症发生率。结果观察组治愈135眼,未愈9眼,治愈率为93.8%。对照组治愈121眼,未愈31眼,治愈率为79.6%,两组治愈率比较差异有统计学意义(P<0.05);观察组出现假道0例,泪小点裂伤1例,上眼睑轻度水肿1例,并发症发生率为1.5%,对照组出现假道3例,泪小点裂伤2例,上眼睑轻度水肿5例,7.5%,两组并发症总发生率比较差异有统计学意义(P<0.05)。结论重复泪道探通术联合冲洗治疗婴幼儿泪囊炎有效,安全性高。

Objective To statistically compare clinical efficacy of continuous probing of lacrimal duct combined with lacrimal irrigation and onventional probing of lacrimal duct combined with lacrimal irrigation in treatment of infant dacryocystitis. Methods Two hundred and sixty eight children （296 eyes） with dacryoeystitis were included in this study. All participants were divided into the observation （n = 134, 144 eyes） and control groups （n = 134, 152 eyes） according to the treatment they received. Patients in the observation group underwent continuous probing of lacrimal duct combined with lacrimal irrigation and those in the control group were treated with single probing of lacrimal duct combined with lacrimal irrigation. Clinical efficacies between two groups were evaluated and postoperative complications were observed. Results In the observation group, 135 eyes were cured with a cure rate of 93.8% （135/144）. In the control group, 121 eyes recovered with a cure rate of 79. 6% （121/152）. A statistical significance was noted between two groups in terms of cure rate （ P 〈 0. 05 ）. In the observation group, no infant had false passage, one with lacrimal puncta laceration and one with mild upper eyelid edema. The incidence rate of postoperative complications was 1.5%. In the control group, three cases presented with false passage, two with lacrimal puncta laceration and five with mild upper eyelid edema. The incidence rate of postoperative complications achieved up to 7. 5%. The incidence rates of postoperative complications between two groups significantly differed （ P 〈 0. 05 ）. Conclusion Continuous probing of lacrimal duct combined with lacrimal irrigation is an efficacious and safe treatment of infant dacryoadenitis.