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目的观察儿童Crawford泪道置管术治疗先天性泪道阻塞的效果。设计回顾性病例系列。研究对象一次或多次泪道探通不成功、年龄在10个月以上的先天性泪道阻塞患儿97例(136眼)。方法首先确定先天性泪道阻塞的类型。全麻下对136眼均行Crawford泪道置管术,术后常规第1天、1周及以后每个月复诊,随诊2～6个月,平均3个月。随诊时观察患儿的症状及行泪道染料排泄试验(DDT)和泪道冲洗。根据病情于术后2～6个月拆除引流管。主要指标流泪、分泌物等症状,DDT及泪道冲洗。结果治疗的136眼中,先天性单纯性泪道阻塞107眼,先天性复杂泪道阻塞22眼,后天性泪道阻塞7眼。治愈121眼(88.97%),有效13眼(9.50%),无效2眼(1.47%)。其中先天性单纯性泪道阻塞治愈率(95.32%)高于其他两组(P=0.000)。作过2次以上泪道探通(39眼)或作过其他泪道手术(8眼)者治愈率(82.05%,57.14%)低于只作过1次治疗组(89眼,95.50%)(P=0.000)。结论儿童Crawford泪道置管术是一种有效的治疗先天性泪道阻塞的方法,可作为泪道多次探通手术不成功或其他泪道置管手术不成功的补充。
Objective To observe the effect of Crawford lacrimal duct placement on congenital lacrimal duct obstruction. Design retrospective case series. One or more lacrimal passages were unsuccessful in one or more subjects, and 97 cases (136 eyes) of congenital lacrimal duct obstruction were older than 10 months. Method First determine the type of congenital lacrimal duct obstruction. A total of 136 eyes under general anesthesia Crawford lacrimal duct placement routine postoperative day 1, 1 and after each referral, followed up for 2 to 6 months, an average of 3 months. Follow-up observation of children with symptoms and line of lacrimal dye excretion test (DDT) and lacrimal duct wash. According to the condition in the postoperative 2 to 6 months to remove the drainage tube. The main indicators of tearing, secretions and other symptoms, DDT and lacrimal irrigation. Results Of the 136 eyes treated, 107 cases of congenital simple lacrimal duct obstruction, 22 cases of congenital lacrimal duct obstruction, and 7 cases of acquired lacrimal duct obstruction. 121 eyes (88.97%) were cured, 13 eyes (9.50%) were effective, and 2 eyes (1.47%) were ineffective. Including congenital simple lacrimal duct obstruction cure rate (95.32%) higher than the other two groups (P = 0.000). The cure rate (82.05%, 57.14%) was lower than that of only one treatment group (89 eyes, 95.50%) after more than 2 times of lacrimal passage exploration (39 eyes) or other lacrimal duct surgery (8 eyes) (P = 0.000). Conclusion Child Crawford lacrimal duct placement is an effective method for the treatment of congenital lacrimal duct obstruction. It can be used as an unsuccessful supplement for lacrimal passage multiple surgeries or other lacrimal duct surgery.