手术显微镜下婴幼儿泪道探通术的效果

EFFICACY OF PROBING OF CONGENITAL NASOLACRIMAL CANAL OBSTRUCTION UNDER OPERATING MICROSCOPE

目的探讨眼科手术显微镜微创探通治疗先天性鼻泪管堵塞的效果及最佳时间。方法眼科手术显微镜微创探通治疗先天性鼻泪管堵塞（手术显微镜组）154例（198眼）,肉眼直视下探通治疗先天性鼻泪管堵塞（肉眼直视组）76例（84眼）。比较两组泪道探通所需时间及出血情况;比较手术显微镜组病儿生后不同时间探通成功率。结果手术显微镜组泪道探通时间短于肉眼直视组,差异有显著性（t=45.87,P〈0.01）。手术显微镜组探通出血率低于肉眼直视组,差异有显著性（χ~2=7.07,P〈0.05）。手术显微镜组4~7月组、8~12月组、〉12月组泪道探通的成功率差异有显著性（χ~2=6.27,P〈0.05）。两组一次探通成功率比较,差异有显著性（χ~2=12.20,P〈0.05）。结论应用眼科手术显微镜对先天性鼻泪管阻塞进行治疗,可以缩短泪道探通时间并且减少出血发生率,提高一次探通的成功率。生后4~7个月是泪道探通较好的时间。

Objective To discuss the efficacy and optimal time of using ophthalmic microscope of micro-probing of congenital nasolacrimal canal obstruction. Methods Using operating microscope for micro-probing of congenital nasolacrimal canal blockage（microscope group）in 154cases（198eyes）,and probing under the naked eye（naked eye group）in 76cases（84eyes）.A comparison between the two groups was done with regard to time used for probing,and bleeding rate.The success rate of probing in operating microscope group in different time after birth was observed. Results The probing time in the microscope group was shorter versus naked eye group（t=45.87,P〈0.01）,and the bleeding rate was also lower（χ~2=7.07,P〈0.05）.As for microscopic group,the differences of success rate of probing in 4-7-month,8-12-month and over-12-month was significant（χ~2=6.27,P〈0.05）.The difference in one-time-probing-success rate between the two groups was significant（χ~2=12.20,P〈0.05）. Conclusion Applying operating microscope for probing of congenital nasolacrimal canal blockage can shorten the time of procedure,decrease the rate of bleeding and increase one-time-success rate of probing.The better time of probing is 4-7months after birth.