摘要:
目的 观察探针式泪道扩张联合鼻内窥镜下泪道插管术治疗儿童复发性泪道阻塞的疗效.方法 选择2013年12月至2015年3月进行探针式泪道扩张联合鼻内窥镜下泪道插管术治疗复发性泪道阻塞患儿84例(106只眼),平均年龄22个月,随访3~16个月.分析患儿年龄、泪道探通次数、泪道阻塞情况对治愈率的影响.使用Pearson相关系数计算及独立样本t检验进行统计学分析.结果 84例(106只眼)中98只眼治愈,总治愈率为92.45% (98/106),总有效率为100% (106/106).年龄因素:6~ 12个月、12 ~ 24个月、24 ~ 36个月、>36个月年龄组治愈率依次为97.22% (35/36)、95.45% (42/44)、88.89% (16/18)、62.50%(5/8)(R=-0.968,P=0.0022);泪道探通次数因素:1次泪道探通术后复发、2次泪道探通术后复发及2次以上泪道探通术后复发患眼中,治愈率分别为95.35%(82/86)、86.67%(13/15)、60.00%(3/5)(R=-0.982,P=0.0014);泪道阻塞情况因素:术中仅1次突破和2次及以上突破分组中,治愈率分别为98.44%(63/64)、83.33% (35/42) (P =0.0003).结论 探针式泪道扩张联合鼻内窥镜下泪道插管术对治疗儿童复发性泪道阻塞疗效显著,手术操作简单,具有较高的安全性,治愈率随年龄增长呈下降趋势,随探通次数增加呈下降趋势,泪道阻塞复杂时治愈率下降.%Objective To study the effect of probe of lacrimal duct dilatation combined with endoscopic lacrimal duct intubation on children with recurrent lacrimal duct obstruction.Methods From December 2013 to March 2015,probe of lacrimal duct dilatation combined with endoscopic lacrimal intubation in the treatment of recurrent lacrimal duct obstruction in 84 cases (106 eyes).The average age was 22 months,and the follow-up was 3-16 months.Analysed the age,the number of lacrimal passage,effect of the cure rate lacrimal duct obstruction.Using the Pearson correlation coefficient calculation and the independent samples t test for statistical analysis.Results Among the 84 cases(106 eyes),cured in 98 eyes,the total cure rate was 92.45% (98/106),and the total effective rate was 100% (106/106).The age factor:in 6-12 months,12-24 months,24-36 months,more than 36 months of age groups,the cure rate was 97.22% (35/36),95.45% (42/44),88.89% (16/18),62.50% (5/8) (R =-0.968,P =0.0022) ; Probing of lacrimal passage number of factors:1 time of recurrent lacrimal surgery,2 times probing of lacrimal passage postoperative recurrence and 2 times more probing of lacrimal passage postoperative recurrence,the cure rates was 95.35% (82/86),86.67% (13/15),60.00% (3/5) (R =-0.982,P =0.0014); Nasolacrimal duct obstruction factors:one block and more than one time blocks 2 groups,the cure rates was 98.44% (63/64),83.33% (35/42) (P =0.0003).Conclusions Probe of lacrimal duct dilatation combined with endoscopic lacrimal duct intubation in the treatment of children with recurrent lacrimal duct obstruction has remarkable curative effect,the operation is simple and has high security.The cure rate decreased with the increase of age.The cure rate decrease with the increase of the number of times.The cure rate decrease when lacrimal duct obstruction is complicated.