不同治療方式治療嬰幼兒淚囊炎的療效分析

諶金金，章 艷，欒國剛，嚴 濤

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·臨床報告·

不同治療方式治療嬰幼兒淚囊炎的療效分析

諶金金，章 艷，欒國剛，嚴 濤

?METHODS: A retrospective study included 218 cases (356 eyes) of infant dacryocystitis were collected and were divided into lacrimal sac massage group, lacrimal passage pressure washing group, lacrimal duct probing group, lacrimal probing combined hormones wash group. The cure rate of different groups was observed.

?RESULTS: As the age grows, the total cure rate showed a downward trend; lacrimal passage pressure washing group showed significant higher cure rate than that of lacrimal sac massage group. Lacrimal duct probing group showed significant higher cure rate than that of lacrimal sac massage group and lacrimal passage pressure washing group. Lacrimal probing combined hormones wash group showed significant higher cure rate than that of lacrimal probing without hormones wash group. The cure rate of upper lacrimal point probing group was significantly better than that of the lower lacrimal point. Meanwhile, as the age grows, the cure rate of the lacrimal sac massage, lacrimal passage pressure washing group and lacrimal probing group decreased (respectivelyr=0.553, 0.437, 0.742,P<0.05). The best therapeutic effect of infants and young children who under the age of 1 is the lacrimal sac massage. For patients under 2 years old, lacrimal probing showed a better cure rate, especially upper lacrimal point probing. For patients over 2 years of age, lacrimal probing combined hormone therapy showed a better cure rate.

?CONCLUSION: For smaller months, patients under 1-year-old, we prefer the lacrimal sac massage, and for patients over 1 year and under 2 years old, lacrimal probing is firstly recommended, upper lacrimal point probing would be better. For patients more than 4 years old should recommend lacrimal probing combined hormones wash treatment.

目的：探討不同治療方式治療嬰幼兒淚囊炎的療效。

方法：回顧性收集2013-01/2015-12就診于我院眼科的嬰幼兒淚囊炎患者218例356眼，治療方式不同分為淚囊區按摩組，淚道加壓沖洗組，單純淚道探通組，淚道探通聯合激素沖洗組。觀察不同分組患兒的治愈率。

結果：隨著患兒年齡的增加，總的治愈率呈明顯下降趨勢；淚道探通組的療效顯著性高于淚道加壓組及淚囊按摩組，淚道加壓沖洗組的療效顯著性高于淚囊按摩組；聯合激素沖洗組療效顯著優于不聯合激素沖洗組。上淚小點探通術治愈率顯著優于下淚小點探通術。隨著患兒年齡的增加，淚囊按摩組、淚道加壓沖洗組和淚道探通組的治愈率不斷降低(r=0.553、0.437、0.742，P<0.05)。

結論：對于月齡較小，1歲以下的患兒首選淚囊區按摩法，而對于1歲～2歲的患兒淚囊按摩無效者推薦淚道探通，上淚小點探通療效更優，而對于2歲以上患兒多推薦淚道探通聯合激素沖洗治療。

淚囊炎；嬰幼兒；療效

引用：諶金金，章艷，欒國剛，等.不同治療方式治療嬰幼兒淚囊炎的療效分析.國際眼科雜志2016;16(12):2338-2341

0引言

嬰幼兒淚囊炎是小兒眼科常見多發疾病，患病率約為5%～6%[1-2]，主要由于新生兒出生時鼻淚管下端的胚胎殘膜未退化或退化不全導致鼻淚管下端阻塞，進而引起淚液或細菌等滯留于淚囊中，表現為淚溢，伴膿性分泌物。目前治療方式多為淚囊區按摩法、淚道加壓沖洗和淚道探通等[3]。……