河北医科大学学报

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改良式泪道插管系统治疗儿童难治性泪道阻塞临床分析

  

  1. 河北省保定市儿童医院眼科,河北 保定 071051
  • 出版日期:2016-02-25 发布日期:2016-04-27
  • 作者简介:韩立坡( 1980- ),男,河北石家庄人,河北省保定市 儿童医院主治医师,医学硕士,从事儿童眼疾病诊治研究。

Clinicalanalysisofthemodifiedlacrimalductintubationsystemintreatmentof#br# childrenwithrefractorylacrimalductobstruction

  1. epartmentofOphthalmology , Chilren '
    sHospitalofBaodingCity , HebeiProvince , Baoding 071051 , China
  • Online:2016-02-25 Published:2016-04-27

摘要: 目的 观察线锯式泪道扩张联合泪道插管手术治疗儿童难治性泪道阻塞的效果,并分析儿童难治性
泪道阻塞治愈率的相关影响因素。方法 收集保定市儿童医院眼科进行线锯式泪道扩张联合泪道插管手术治疗难
治性泪道阻塞患儿 306 例( 426 只眼),中位数年龄 1.
5 岁,随访 3~18 个月。分析患儿年龄、术前治疗手段对患儿治
愈率的影响。采用 Pearson 相关分析进行统计学处理。结果 306 例( 426 只眼)中 386 只眼达到治愈标准,总治愈
率为 90.
6% ( 386 / 426 )。年龄因素:在 6~12 个月、 >12~24 个月、 >24~36 个月、 >36 个月年龄组中,治愈率依次
为 96.6% ( 112 / 116 )、 91.3% ( 168 / 184 )、 86.0% ( 74 / 86 )、 80.0% ( 32 / 40 )( r =-0.
960 , P =0.002 )。术前治疗手段
因素:曾患先天性泪道阻塞行泪道探通术后失败患儿、曾患先天性泪道阻塞行单纯泪道插管术后失败患儿的 2 个
分组中,治愈率分别为 93.6% ( 322 / 344 )、 78.0% ( 64 / 82 )( P =0.004 )。结论 线锯式泪道扩张联合泪道插管手术
对儿童难治性泪道阻塞治疗效果明显,具有较高的安全性,治愈率随年龄增长呈下降趋势;泪道探通失败患儿,行
线锯式泪道扩张联合泪道插管治疗较单纯泪道插管治疗术后效果明显提高。

关键词: 鼻泪管, 泪器阻塞, 儿童

Abstract:  Objective Tostudytheeffectofwiretypelacrimalductdilatationcombinedwith
lacrimalductintubationoperation in treatment of children with refractory lacrimal duct
obstruction , andtoanalysizerelatedfactorsaffectingthecurerateinchildren'srefractory
lacrimalductobstruction.Methods Intreatmentofrefractorylacrimalductobstruction , 306
cases ( 426eyes ), theaveragedageof1yearsold , followed-upfor3-18monthswerecollected.
Thosepatientsweretreatedbysawtypelacrimalductexpansioncombinedwithlacrimalduct
intubationsurgeryinthedepartmentofophthalmologyofBaodingchildren'shospital.Analysis
theinfluence ofpatientageand preoperativetreatmenton curerate.Pearson correlation
coefficientwasusedforstatisticalanalysis.Results Intotalof306cases ( 426eyes ), 386eyes
werefittedwithcriterionofcure.Thetotalcureratewas90.6% ( 386 / 426 ) .Theagefactor : the
cureratein6~12monthsgroups , 12monthsto24monthsgroups , 24monthsto36months
groups , andmorethan36monthsgroups , thecureratewas96.6% (
112 / 116 ), 91.3%
(
168 /
184 ), 86.0% ( 74 / 86 ), 80.0% ( 32 / 40 )( r =-0. 960 , P =0.002 ) .Preoperativetreatmentfactors :
thecurerateinprobingoflacrimalpassageafterfailureofchildren , childrenwithpurelacrimal
ductintubationfailedafter2groupswere : 93.6% ( 322 / 344 ), 78.0% ( 64 / 82 )( P =0.004 ) . Conclusion Treatmenteffectinwiretypelacrimalductdilatationcombinedwithlacrimalduct
intubationoperationforchildrenwithrefractorylacrimalductobstructionwasobvious , andwith
highsecurity.Thecureratewasdecreased withtheincreaseofage.Sawtypelacrimalduct
dilatationcombined withlacrimalductintubationtreatmentsignificantlyimprovedtreatment
effectscomparetosimplelacrimalintubationforpostoperativeeffectofinchildren withthe
probingoflacrimalpassagefailure.

Key words: nasolacrimalduct , lacrimalductobstruction , children