作者：曾庆广，曾妍,左志高,马恩普,晁炜静 作者单位：450052)中国河南省郑州市,武警河南总队医院1眼科;2军人门诊
【摘要】 目的：研究泪道探通加冲洗治疗婴幼儿泪囊炎的临床疗效。
【关键词】 泪道探通；冲洗；治疗；婴幼儿；泪囊炎
Clinical research of probing of lacrimal passage and irrigating to treat infant dacryocystitis QingGuang Zeng, Yan Zeng, ZhiGao Zuo, EnPu Ma, WeiJing Chao Department of Ophthalmology, Henan Provincial Corps Hospital, Chinese Peoples Armed Police Forces, Zhengzhou 450052, Henan Province, China; Soldier Clinic Service, Henan Provincial Corps Hospital, Chinese Peoples Armed Police Forces, Zhengzhou 450052, Henan Province, China Abstract
AIM: To research the clinical effect of probing of lacrimal passage and irrigating to treat infant dacryocystitis.
METHODS: Using the No.7 waist puncture needle selfmade lachrymal conduit probing and irrigating appliance. After mucous membrane anaesthesia, the patients were stopped moving. According to routine probing operation, after puncta sufficient dilating, lachrymal conduit probing and irrigating appliance was drilled through lacrimal puncta，canaliculi，lacrimal sac，membrane and nasolacrimal duct. After the needle core was pulled out, the patients were irrigated with 2g/L levofloxacin rinse liquid until the infant appearred swallowing action or choking rinse liquid.
RESULTS: Lacrimal passages of 33 cases（eyes）with dacryocystisis were unobstructed after treatment all at once. 5 cases（15%）were cured for one time.
CONCLUSION: Probing of lacrimal passage and irrigating to treat infant dacryocystitis is simple, timesaving, of little damage, better treating effect, convenience and easy acceptance by infants dependents, and is a good method for the treatment of this disease at present.
KEYWORDS: probing of lacrimal passage; irrigating; treatment; infant; dacryocystitis
方法：采用7号腰穿针自制的泪道探通冲洗器，黏膜麻醉后，止动。充分扩张泪小点后,将泪道探通冲洗器按常规探通术，由泪小点，泪小管，泪总管，泪囊，穿破隔膜及泪鼻管后，拔出针芯，接冲2g/L盐酸左氧氟沙星冲洗液，边退边冲，患儿出现吞咽动作或呛咳出冲洗液为度。
结果：采用此方法治疗婴幼儿泪囊炎33例33眼均为一次性通畅。再次行泪道冲洗者5例5眼（15%），均为一次性治愈。
结论：采用泪道探通加冲洗治疗婴幼儿泪囊炎，方法简便、省时，损伤小，疗效快捷，方便，患儿家属易接受。是目前治疗该病症的好方法。
0引言
婴幼儿泪囊炎是一种常见的小儿先天性眼科疾病；由于鼻泪管下端的胚胎残膜没有退化，阻塞鼻泪管下端，泪液和细菌潴留在泪囊内，引起继发性感染所致。临床表现为婴儿出生以后，1眼或双眼泪液并有较多分泌物，常被误认为结膜炎。压迫泪囊有黏液或脓性分泌物溢出。少数病例可由骨部狭窄或鼻部畸形造成泪道阻塞。我院自198508/200908采用7号腰穿针自制成泪道探通冲洗器治疗先天性婴幼儿泪囊炎33例33眼，效果满意现报告如下。
1对象和方法 1.1对象 年龄5天龄～3岁婴幼儿33例33眼，男18例18眼，女婴25例25眼。病程5d～3a，右眼17眼、左眼26眼，监护人主诉为出生后患眼溢泪、有脓性分泌物溢出，并且均为局部按摩及滴抗生素眼液无效者。治疗材料与器械：取7～8号腰穿针，将尖部磨钝而光滑，制成泪道探通冲洗器[1]，消毒后备用，常规泪道冲洗器材，泪小点扩张器。
1.2方法 给患儿术眼滴40g/L的盐酸奥布卡因表面麻醉滴眼液，2滴/次。让监护人为患儿捧头夹双上臂,使患儿头、颈及上肢止动，常规术区消毒，用泪小点扩张器扩张下泪小点及泪小管后，采用自制7号泪道探通冲洗器，按泪道探通常规术由泪小点、泪小管、泪总管、泪囊及鼻泪管，泪道隔膜探通后，拔出探针芯，将2g/L盐酸左氧氟沙星注射液2mL，边注边退注入泪道内，患儿出现吞咽动作及口、鼻呛咳出注入液为通畅。嘱术眼滴泰利必妥眼液3～4次/d。必要时隔日再次冲洗泪道。
2结果
33例33眼患儿，采取上述方法，1次探通冲洗治愈者33例，隔日再冲洗者5例5眼（15%）术后随访4～5a，患儿无溢泪、溢脓等现象为治愈。未见特殊并发症。
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