泪道冲洗和泪道探通治疗3 558例先天性泪道阻塞的时机及方法探讨

岑超; 何俐莹; 陶雪莹; 刘娅

doi:10.16016/j.1000-5404.202106045

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泪道冲洗和泪道探通治疗3 558例先天性泪道阻塞的时机及方法探讨

临床医学 | 更新时间：2026-01-09

- 泪道冲洗和泪道探通治疗3 558例先天性泪道阻塞的时机及方法探讨
- Timing and method of lacrimal duct irrigation and probing in treatment of congenital nasolacrimal duct obstruction: a retrospective study of 3 558 cases
- 第三军医大学学报 2021年43卷第23期页码：2590-2595
- 作者机构：
  
  400021 重庆，重庆市妇幼保健院眼耳鼻喉科
- 作者简介：
  
  [何俐莹，E-mail：489574008@qq.com HE Liying, E-mail: 489574008@qq.com
- 基金信息：
  
  重庆社会事业与民生保障科技创新专项重点研发项目(CSTC2017shms-zdyfX0049)
- DOI：10.16016/j.1000-5404.202106045
  中图分类号： R615;R777.22
- 收稿：2021-06-06，
  
  修回：2021-06-30，
  
  纸质出版：2021-12-15
- 稿件说明：
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岑超, 何俐莹, 陶雪莹, 等. 泪道冲洗和泪道探通治疗3 558例先天性泪道阻塞的时机及方法探讨[J]. 第三军医大学学报, 2021,43(23):2590-2595.

Chao CEN, Liying HE, Xueying TAO, et al. Timing and method of lacrimal duct irrigation and probing in treatment of congenital nasolacrimal duct obstruction: a retrospective study of 3 558 cases[J]. Journal of Third Military Medical University, 2021, 43(23): 2590-2595.
岑超, 何俐莹, 陶雪莹, 等. 泪道冲洗和泪道探通治疗3 558例先天性泪道阻塞的时机及方法探讨[J]. 第三军医大学学报, 2021,43(23):2590-2595. DOI： 10.16016/j.1000-5404.202106045.

Chao CEN, Liying HE, Xueying TAO, et al. Timing and method of lacrimal duct irrigation and probing in treatment of congenital nasolacrimal duct obstruction: a retrospective study of 3 558 cases[J]. Journal of Third Military Medical University, 2021, 43(23): 2590-2595. DOI： 10.16016/j.1000-5404.202106045.

摘要

目的

探讨先天性泪道阻塞(congenital nasolacrimal duct obstruction，CNLDO)行泪道冲洗及泪道探通的最佳治疗时机及治疗方法。

方法

采用回顾性分析，选取2017年4月至2020年12月于重庆市妇幼保健院就诊的3 558例(5 514只眼)CNLDO患儿，共5 514只眼，根据患儿性别、分娩方式、治疗月龄进行分组，比较各组间泪道冲洗成功率的差异。对723例(723只眼)行泪道探通治疗的患儿按照月龄、泪道冲洗次数进行分组，比较各组间1次性探通成功率的差异。

结果

泪道冲洗治疗结果显示，

2月龄患儿1次通畅率最高，为66.36%，2~4月龄、

4~6月龄和

6月龄患儿1次通畅率分别为46.25%、38.05%和28.64%，不同月龄组间差异具有统计学意义(

0.001)；泪道冲洗的通畅率与分娩方式无关(

0.05)，男性冲洗通畅率(46.38%)大于女性(39.39%)(

0.05)。泪道探通术治疗结果也显示，患儿月龄越小、泪道冲洗次数越少，1次性探通成功率越高(

0.01)。

结论

先天性泪道阻塞行泪道冲洗及泪道探通治疗的时机越早，效果越好。在多次泪道冲洗不通畅时结合泪道探通术可有效治疗先天性泪道阻塞。

Abstract

Objective

To explore the best time and method of lacrimal duct irrigation and probing in the treatment of children with congenital nasolacrimal duct obstruction (CNLDO).

Methods

A total of 3 558 children with CNLDO (5 514 eyes) who were treated in our hospital from April 2017 to December 2020 were enrolled and retrospectively analyzed. They were divided into groups according to their gender

delivery mode and treatment age

and the success rate of lacrimal duct irrigation was compared among the corresponding groups. In addition

723 of the patients (723 eyes) who underwent lacrimal duct probing therapy were grouped according to their age and number of lacrimal duct irrigation

and the success rate of one-time patency was compared among the corresponding groups.

Results

In terms of lacrimal duct irrigation

the one-time patency rate was the highest in children aged

2 months (66.36%)

along with 46.25%

38.05% and 28.64% in children aged 2~4 months

4~6 months and

6 months

respectively

showing significant difference in age groups (

0.001). In addition

the patency rate of lacrimal duct irrigation was independent of the childbirth mode (

0.05)

and the patency rate of boys (46.38%) was higher than that of the girls (39.39%

0.05). As for the lacrimal duct probing

the treatment Results showed that the younger the children and the fewer the times of duct irrigation were

the higher the success rate of one-time patency of probing achieved (

0.01).

Conclusion

Earlier lacrimal duct irrigation and probing in the treatment for CNLDO will lead to better therapeutic efficacy. CNLDO can be effectively cured by lacrimal duct probing when repeated lacrimal duct irrigation fails.

关键词

Keywords

references

项道满, 于刚. 儿童眼病诊疗常规[M]. 北京: 人民卫生出版社, 2014: 92-93.

XIANG D M, YU G. Diagnosis and treatment of children's ophthalmopathy[M]. Beijing: People's Medical Publishing House, 2014: 92-93.

吴倩, 于刚, 全晓杰, 等. 先天性泪道阻塞2248例回顾性分析[J]. 中国斜视与小儿眼科杂志, 2008, 16(2): 80-82. DOI: 10.3969/j.issn.1005-328X.2008.02.013.

WU Q, YU G, QUAN X J, et al . Retrospective analysis of 2248 cases of congenital lacrimal duct obstruction[J ] . Chin J Strabismus Pediatr Ophthalmol, 2008, 16(2): 80-82. DOI: 10.3969/j.issn.1005-328X.2008.02.013.

ALAKUS M F, DAG U, BALSAK S, et al . Is there an association between congenital nasolacrimal duct obstruction and cesarean delivery?[J ] . Eur J Ophthalmol, 2020, 30(6): 1228-1231. DOI: 10.1177/1120672119889522.

DURRANI J. Crigler massage for congenital blockade of nasolacrimal duct[J]. J Coll Physicians Surg Pak, 2017, 27(3): 145-148.

傅征, 杨晖, 肖雪华, 等. 401例先天性泪囊炎患儿采用不同方案治疗的临床疗效观察[J]. 中国卫生标准管理, 2019, 10(1): 74-76. DOI: 10.3969/j.issn.1674-9316.2019.01.032.

FU Z, YANG H, XIAO X H et al . Clinical observation of 401 cases of congenital dacryocystitis treated with different regimens[J ] . China Heal Stand Manag, 2019, 10(1): 74-76. DOI: 10.3969/j.issn.1674-9316.2019.01.032.

曾朝霞, 梁艳丽, 陈荟郦, 等. 婴幼儿先天性泪道阻塞320例临床分析[J]. 现代医院, 2015, 6(11): 57-58. DOI: 10.3969/j.issn.1671-332X.2015.11.021.

ZENG Z X, LIANG Y L, CHEN H L, et al . Clinical analysis of 320 cases of congenital nasolacrimal duct obstruction in infant[J ] . Mod Hosp, 2015, 6(11): 57-58. DOI: 10.3969/j.issn.1671-332X.2015.11.021.

PALO M, GUPTA S, NAIK M N, et al . Congenital nasolacrimal duct obstruction and its association with the mode of birth[J ] . J Pediatr Ophthalmol Strabismus, 2018, 55(4): 266-268. DOI: 10.3928/01913913-20180213-03.

闫利锋, 徐秀娟, 周瑾, 等. 新生儿泪囊炎发病危险因素的病例对照研究[J]. 中山大学学报(医学科学版), 2012, 33(4): 541-543, 548. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2012.0128.

YAN L F, XU X J, ZHOU J, et al . Case-control study on risk factors of neonatal dacryocystitis[J ] . J Sun Yat Sen Univ Med Sci, 2012, 33(4): 541-543, 548. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2012.0128.

TAKAHASHI Y, NAKATA K, MIYAZAKI H, et al . Comparison of bony nasolacrimal canal narrowing with or without primary acquired nasolacrimal duct obstruction in a Japanese population[J ] . Ophthalmic Plast Reconstr Surg, 2014, 30(5): 434-438. DOI: 10.1097/IOP.0000000000000238.

周浩, 李雷激. 应用CT泪道造影评估骨性鼻泪管形态变化与鼻泪管阻塞发生的相关性[J]. 昆明医科大学学报, 2018, 39(10): 46-50. DOI: 10.3969/j.issn.1003-4706.2018.10.010.

ZHOU H, LI L J. The angle between the bony nasolacrimal duct and the nasal base plane in patients with nasolacrimal duct obstruction: an CT angiographic study of lacrimal duct[J]. J Kunming Med Univ, 2018, 39(10): 46-50. DOI: 10.3969/j.issn.1003-4706.2018.10.010.

王素贞, 王杰, 王宁利, 等. 慢性泪囊炎患者泪囊长轴与骨性鼻泪管夹角的研究[J]. 国际眼科杂志, 2021, 21(1): 137-139. DOI: 10.3980/j.issn.1672-5123.2021.1.27.

WANG S Z, WANG J, WANG N L, et al . Study on the angle between the long axis of lacrimal sac and bony nasolacrimal duct in patients with chronic dacryocystitis[J ] . Int Eye Sci, 2021, 21(1): 137-139. DOI: 10.3980/j.issn.1672-5123.2021.1.27.

凌博, 陈水生, 戚翠萍. 不同时机应用泪道探通术治疗先天性泪道阻塞的疗效对比[J]. 实用临床医学, 2020, 21(1): 67-69.

LING B, CHEN S S, QI C P et al . Comparison of effects of lacrimal passage probing performed at different times on neonatal dacryocystiti[J ] . Pract Clin Med, 2020, 21(1): 67-69.

黄素珍, 骆冬梅, 黄恩娥. 两种泪道探通方式治疗新生儿泪囊炎的疗效观察[J]. 中国初级卫生保健, 2013, 27(6): 130-131.

HUANG S Z, LUO D M, HUANG E E. Observation on the curative effect of two probing methods in the treatment of neonatal dacryocystitis[J]. Chin Prim Heal Care, 2013, 27(6): 130-131.

VAGGE A, DESIDERI L F, NUCCI P, et al . Congenital nasolacrimal duct obstruction (CNLDO): a review[J ] . Diseases, 2018, 6(4): 96. DOI: 10.3390/diseases6040096.

BHANDARI S, SENGUPTA S, YADA LLA D, et al . Factors affecting treatment outcome in congenital nasolacrimal duct obstruction: a retrospective analysis from South India[J ] . Indian J Ophthalmol, 2015, 63(10): 759-762. DOI: 10.4103/0301-4738.171503.

KOTHARI M, RATHOD V, SHAH K, et al . Congenital nasolacrimal duct obstruction: Should we continue lacrimal massage till 1 year or perform an office probing at 6 months? A clinical decision analysis approach[J ] . Indian J Ophthalmol, 2017, 65(2): 167-169. DOI: 10.4103/ijo.IJO_245_16.

PAUL T O, SHEPHERD R. Congenital nasolacrimal duct obstruction: natural history and the timing of optimal intervention[J]. J Pediatr Ophthalmol Strabismus, 1994, 31(6): 362-367.

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