摘要目的 观察球囊管扩张联合泪道插管治疗儿童难治性泪道阻塞的疗效及影响因素.方法 回顾性分析.2013年9月至2015年9月,对就诊于保定市儿童医院眼科的68例(72只眼)经泪道探通、泪道插管、球囊管扩张术后失败的泪道阻塞患儿局麻下进行球囊管扩张联合泪道插管手术治疗,随访时间为术后3～18个月.结果 68例(72只眼)患儿中63只眼达到治愈标准,总治愈率为87.50％(63/72);9只眼术后好转;总有效率100％ (72/72).年龄分组:在12月龄～＜24月龄、24月龄～＜36月龄、≥36月龄组中,治愈率依次为96.15％ (25/26)、89.29％ (25/28)、72.22％ (13/18)(R=-0.86,P =0.0016),治愈率随年龄增长呈下降趋势.术前采用过不同治疗方法分组:泪道探通术后失败、单纯泪道插管术后失败、单纯球囊管扩张术后失败的3个分组中,治愈率分别为97.37％ (37/38)、75.00％ (12/16)、77.78％ (14/18),将泪道探通术后失败组和单纯泪道插管术后失败组进行x2检验,差异有统计学意义(x2=6.705,P＜0.05);将泪道探通术后失败组和单纯球囊管扩张术后失败组进行x2检验,差异有统计学意义(x2=5.765,P ＜0.05).结论 球囊管扩张联合泪道插管术治疗儿童难治性泪道阻塞是一种便捷、安全、有效的新型手术方式,适用于儿童难治性泪道阻塞的治疗,疗效好.

abstractsObjective To observe the effect and influencing factors of Balloon tube dilatation combined with lacrimal duct intubation in treatment of children refractory lacrimal duct obstruction.Methods From September 2013 to September 2015,under local anesthesia of 68 cases (72 eyes) with recurrent lacrimal duct obstruction were treated to probe type balloon catheter dilatation combined with lacrimal duct intubation.Follow up time was 3 to 18 months after operation.Results In 68 cases (72 eyes),63 eyes were cured,the total cure rate was 87.50％ (63/72),9 eyes were improved,the total effective rate was 100％ (72/72).Age group:in 12 months≤～＜24 months,24 months≤～＜36 months,≥36 months of age groups,the cure rate followed by.96.15％ (25/26),89.29％ (25/28),72.22％ (13/18)(R =-0.86,P =0.0016),the cure rate was exhibited a decreasing trend along with the increase of age.Preoperative by different methods in the treatment group:for probing of lacrimal passage after failure,simple lacrimal duct intubation and balloon dilation after failure of three groups cure rate were 97.37％(37/38),75.00％(12/16),77.78％(14/18).The lacrimal surgery failure group and simple lacrimal duct intubation after failure group x2 test,the difference was statistically significant(x2=6.705,P ＜0.05);The lacrimal surgery failure group and balloon dilatation tube failure group x2 test,the difference was statistically significant(x2=5.765,P ＜0.05).Conclusions Balloon catheter dilatation combined with lacrimal intubation in the treatment of children refractory lacrimal duct obstruction is a convenient,safe and effective new surgical method for treatment in children with refractory lacrimal duct obstruction,curative effect is good.