李沙 陈琳 刘兵 张咏

[摘要] 目的 研究分析聯合使用塞纳斯的泪道探通术治疗膜性阻塞的婴幼儿泪囊炎的临床疗效。方法 病例对照研究。方便收集2015年10月—2018年4月于汉口爱尔眼科医院泪道科就诊的符合泪道探通术治疗指征的婴幼儿泪囊炎（膜性阻塞）患者资料 342例（351眼）作为研究对象，年龄为3～10月龄不等，随机分为两组，对照组170例（174眼）行单纯的泪道探通治疗，实验组172例（177眼）使用塞纳斯联合泪道探通术。术后1个月、2个月、3个月复查，观察患儿溢泪、溢脓情况及泪道通畅情况。 结果 对照组泪道探通术后有148眼治愈，成功率约为85%，实验组泪道探通术联合应用塞纳斯后有172眼治愈，成功率约为97%，差异有统计学意义（χ2=16.000，P<0.05）。 结论 泪道探通术是目前公认的治疗婴幼儿泪囊炎（膜性阻塞）的最有效方法，但存在一定的一次手术失败率，塞纳斯的联合使用能有效地阻止鼻泪管末端的残膜再生，同时促进黏膜的恢复，防止粘连，大大提高了泪道探通术对婴幼儿泪囊炎的临床疗效，增加了一次手术的成功率，同时在一定程度上减少了患儿的痛苦。

[关键词] 塞纳斯;泪道探通术;婴幼儿泪囊炎;膜性阻塞

[中图分类号] R777          [文献标识码] A          [文章编号] 1674-0742（2019）11（a）-0028-04

Therapeutic Study of Membranous Obstruction in Infants with Dacryocystitis

LI Sha， CHEN Lin， LIU Bing， ZHANG Yong

Department of Lacrimalology， Hankou Hospital， Wuhan Aier Eye Hospital， Wuhan， Hubei Province， 430000 China

[Abstract] Objective To study the clinical efficacy of combined use of Seinus's lacrimal passage in the treatment of dacryocystitis in infants with membranous obstruction. Methods Case-control study. 342 cases （351 eyes） of infants with dacryocystitis （membrane obstruction） inoculated in the lacrimal sinus department of Hankou Aier Eye Hospital from October 2015 to April 2018 were Convenient collected. The subjects， aged from 3 months to 10 months， were randomly divided into two groups. 170 patients （174 eyes） in the control group underwent simple lacrimal passage therapy， and 172 patients （177 eyes） in the experimental group were treated with Senas lacrimal passage probing. The patients were reviewed in one， two， three months， and the children were observed for tears， pus and sputum. Results In the control group， 148 eyes were cured after the lacrimal passage， and the success rate was about 85%. In the experimental group， 172 eyes were cured after the application of the lacrimal passage， and the success rate was about 97%. The difference was statistically significant（χ2=16.000， P<0.05）. Conclusion Lacrimal probing is currently the most effective method for the treatment of dacryocystitis （membranous obstruction） in infants， but there is a certain rate of surgical failure. The combination of Senus can effectively prevent the end of the nasolacrimal duct. Residual membrane regeneration， while promoting mucosal recovery， preventing adhesions， greatly improving the clinical efficacy of lacrimal passage exploration on infantile dacryocystitis， increasing the success rate of one operation， and reducing the pain of children to some extent.

[Key words] Senas; Lacrimal passage; Infantile dacryocystitis; Membranous obstruction

婴幼儿泪囊炎又称先天性泪囊炎，是先天性泪道发育障碍所致，大部分患儿是由于出生时鼻泪管末端的胚胎残膜Hasner瓣未完全退化，从而造成婴幼儿泪道的膜性阻塞，是婴幼儿常见眼科疾病，经常单眼或双眼发病，约占新生儿的5%左右[1]。主要表现为患儿出生后不久（7～10 d，多在1月以内出现症状）即有溢泪、溢脓的症状，压迫泪囊区可见黏液或脓性分泌物自泪点溢出，如不及时治疗可引起急性泪囊炎、泪囊瘘、角膜感染等严重后果[2-3]。该文采用病例对照研究，对2015年10月—2018年4月来该院就诊的342例（351眼）膜性阻塞的婴幼儿泪囊炎患者进行临床研究，分析联合使用塞纳斯的泪道探通术对婴幼儿泪囊炎的临床疗效，现报道如下。……