婴幼儿泪囊炎的综合治疗方法

Comprehensive Therapy of Infant Dacryocystitis

目的探讨治疗婴幼儿泪囊炎的最佳治疗时机和治疗方法。方法选择广州医科大学第二附属医院眼科门诊2010年1月至2014年12月124例147只眼婴幼儿泪囊炎患儿，分为1-12月（婴儿组），12-36月（幼儿组）两组分别观察。采用综合性治疗方法：泪囊按摩，滴抗生素眼液，冲洗泪道，泪道探通术，泪道置管术。结合患儿的实际情况，给予有限的保守治疗，积极的泪道探通或置管治疗。结果确诊为婴幼儿泪囊炎，保守治疗后症状缓解，但不能痊愈，婴儿组行单纯泪道探通术，治愈率有94.46%；幼儿组单纯泪道探通治愈率65.71%；婴儿组治愈率比幼儿组高，差异有统计学意义（P〈0.05）。幼儿组结合泪道置管治疗后，治愈率明显提高，治愈率94.29%，婴儿组与幼儿组治愈率差异无统计学意义（P〉0.05）。结论婴幼儿泪囊炎，采取综合性治疗是确当的方法，有限的保守治疗，积极的泪道探通或置管术是可行的，适于临床应用，是治愈该病的有效方法。

Objective To explore the optimum timing and treatment method of dacryocystitis in the newborn. Methods Randomly selected 124 cases of neonatal dacryocystitis consisting of 147 eyes from ophthalmology clinics from January 2010 to December 2014. The cases were divided into two observation age groups： 1-12 months （infant group）, and 〉12-36 months （toddler group）. Treat- ment methods included massage, flushing, probing and flushing of the lacrimal passage, lacrimal ca-nal intubation, and antibacterial eye drops. Results Conservative treatment could relieve the symptoms but could not cure neonatal dacryocystitis. The recovery rates of those who were only treated with probing of the lacrimal passage： infant group 94.46% and toddler group 65.71%. The recovery rate of infant group was statistically significantly （P 〈0.05） higher than that of the toddler group. Toddler group treated also with lacrimal canal intubation had a recovery rate of 94.29%, which had no statistically significant （P 〉0.05） difference than that of the infant group. Conclusions It is recommended to use combination of methods to treat neonatal dacryocystitis. Both limited use of conservative methods and aggressive treatment, such as lacrimal canal intubation, are effective in clinical USES.