摘要目的:探讨泪囊按摩、泪道冲洗联合泪道探通术治疗先天性泪囊炎的有效性与安全性。方法:采取前瞻性研究方法，将2021年1月至2023年12月在绍兴市妇幼保健院眼科收治的150例先天性泪囊炎患儿按照随机数字表法分成对照组与观察组，对照组（75例）予以泪囊按摩、泪道冲洗治疗，观察组（75例）予以泪囊按摩、泪道冲洗联合泪道探通术治疗。观察比较两组的溢泪程度评分、炎性因子水平［C反应蛋白（CRP）］、临床疗效、并发症（假道、眼睑水肿、泪道黏膜损伤）等。结果:观察组治疗后3个月的溢泪程度评分为（1.55±0.39）分，低于对照组的（2.62±0.58）分，差异有统计学意义（ t=13.26， P < 0.05）；观察组治疗后3个月的CRP为（1.38±1.10）mg/L，低于对照组的（3.14±1.27）mg/L，差异有统计学意义（ t=9.07， P < 0.05）；观察组治愈率为97.33%（73/75），高于对照组的88.00%（66/75），差异有统计学意义（ χ2=4.81， P < 0.05）；观察组并发症发生率为9.33%（7/75），与对照组的6.67%（5/75）相近，差异无统计学意义（ χ2=0.36， P > 0.05）。 结论:泪囊按摩、泪道冲洗联合泪道探通术治疗先天性泪囊炎的效果较好，能够减轻溢泪程度，降低炎症因子水平，总有效率高，且并发症少。

abstractsObjective:To investigate the efficacy and safety of lacrimal sac massage, lacrimal duct lavage, and dacryocystorhinostomy in combination for the treatment of congenital dacryocystitis.Methods:This study used a prospective study design, enrolling 150 children diagnosed with congenital dacryocystitis who received treatment at the Department of Ophthalmology, Shaoxing Maternity and Child Healthcare Hospital between January 2021 and December 2023. The children were randomly assigned to either a control group or an observation group using a random number table method. The control group ( n = 75) received lacrimal sac massage and lacrimal duct lavage, while the observation group ( n = 75) underwent a combination of lacrimal sac massage, lacrimal duct lavage, and dacryocystorhinostomy. Tear secretion score, level of inflammatory factor C-reactive protein, clinical efficacy, and complications (false passages, eyelid edema, and damage to the lacrimal duct mucosa) were compared between the two groups. Results:At 3 months after treatment, tear secretion score in the observation group was significantly lower than that in the control group [(1.55 ± 0.39) vs. (2.62 ± 0.58), t = 13.26, P < 0.05). At 3 months after treatment, the C-reactive protein level in the observation group was significantly lower than that in the control group [(1.38 ± 1.10) mg/L vs. (3.14 ± 1.27) mg/L, t = 9.07, P < 0.05). The cure rate in the observation group was significantly higher than that in the control group [97.33% (73/75) vs. 88.00% (66/75), χ2 = 4.81, P < 0.05]. There was no significant difference in the incidence of complications between the observation and control groups [9.33% (7/75) vs. 6.67% (5/75), χ2 = 0.36, P > 0.05]. Conclusions:The combination of lacrimal sac massage, lacrimal duct irrigation, and lacrimal duct probing has shown good efficacy in treating congenital dacryocystitis. This approach can decrease the severity of tearing, reduce the levels of inflammatory factors, achieve a high overall response rate, and lead to fewer complications.