年龄因素对先天性鼻泪管阻塞泪道探通术治疗效果的影响

doi:10.16352/j.issn.1001-6325.2024.05.0709

基础医学与临床 ›› 2024, Vol. 44 ›› Issue (5): 709-713.doi: 10.16352/j.issn.1001-6325.2024.05.0709

年龄因素对先天性鼻泪管阻塞泪道探通术治疗效果的影响

吴幸之, 孙华, 丁静文^*

首都医科大学附属北京同仁医院眼科,北京 100730

收稿日期:2024-02-19 修回日期:2024-03-19 出版日期:2024-05-05 发布日期:2024-04-23
通讯作者: ^*jingwending@yeah.net

Effect of age on the success rate of lacrimal probing in the congenital nasolacrimal duct obstruction

WU Xingzhi, SUN Hua, DING Jingwen^*

Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China

Received:2024-02-19 Revised:2024-03-19 Online:2024-05-05 Published:2024-04-23
Contact: ^*jingwending@yeah.net

摘要/Abstract

摘要： 目的探讨年龄因素对先天性鼻泪管阻塞(CNLDO)泪道探通术治疗效果的影响。方法本研究为单中心回顾性病例研究,采用阶梯式治疗方案对保守治疗无效的患儿适时行泪道探通术,根据患儿年龄分为0～＜6月、6～＜12月、12～＜24月和24～60月龄4组,对比分析各组的手术成功率及其与患儿年龄的相关性。结果共纳入269例患儿314只眼,4个年龄组一次泪道探通成功率分别为86.8%、91.7%、73.6%和37.8%,所有患儿泪道探通总成功率为84.7%(266/314)。12月龄以后探通总成功率下降与年龄增加呈显著相关(P=0.000),与患儿性别和眼别无显著相关性(P=0.255和0.708)。结论阶梯式方案治疗CNLDO 安全有效,泪道探通术的成功率与年龄呈负相关,可作为2岁以下患儿保守治疗无效的首选手术方法。

关键词: 先天性鼻泪管阻塞, 年龄, 溢泪, 探通, 置管

Abstract: Objective To explore the effect of age factor on the success rate of lacrimal probing in the congenital nasolacrimal duct obstruction (CNLDO). Methods This report was based on a single-center retrospective case series study. The gradient therapeutic regimen was adopted, and lacrimal probing was undertaken to treat CNLDO when conservative treatment was ineffective. The patients were categorized into 4 groups by age: 0-＜6 months,6-＜12 months,12-＜24 months and 24-60 months. The success rate of probing in each group was compared and the correlation with age was analyzed. Results A total of 314 eyes of 269 patients were included. The success rates of primary probing in 4 groups were 86.8%, 91.7%, 73.6% and 37.8%, respectively. The overall success rate of probing in all patients was 84.7%(266/314). The decreased success rate of probing at age beyond 12 months was significantly correlated with increasing age(P＜0.001). No significant correlation was found with sex or laterality. Conclusions Staged treatment strategy is safe and effective. The success rate of probing is negatively correlated with age. Initial probing is recommended in children under 2 with failure of the conservative management.

Key words: congenital nasolacrimal duct obstruction, age, epiphora, probing, stenting

中图分类号:

R779.7

吴幸之, 孙华, 丁静文. 年龄因素对先天性鼻泪管阻塞泪道探通术治疗效果的影响[J]. 基础医学与临床, 2024, 44(5): 709-713.

WU Xingzhi, SUN Hua, DING Jingwen. Effect of age on the success rate of lacrimal probing in the congenital nasolacrimal duct obstruction[J]. Basic & Clinical Medicine, 2024, 44(5): 709-713.

参考文献

[1] MacEwen CJ, Young JD. Epiphora during the first year of life[J]. Eye (Lond), 1991,5:596-600.
[2] Mohney BG, Sathiamoorthi S, Frank RD. Spontaneous resolution rates in congenital nasolacrimal duct obstruction managed with massage or topical antibiotics compared to observation alone[J]. Br J Ophthalmol,2022,106:1196-1199.
[3] Ali MJ, Kamal S, Gupta A, et al. Simple vs complex congenital nasolacrimal duct obstructions: etiology, management and outcomes[J]. Int Forum Allergy Rhinol,2015,5:174-177.
[4] Farrokhi S, Schüttauf F, Spitzer MS, et al. Congenital nasolacrimal obstruction: a real-life study from the first symptoms to the results of surgical treatment[J]. Ophthalmologe,2021,118:1031-1037.
[5] Sun H, Ding J, Li D, et al. Comparison of Hasner valvulotomy outcomes in pediatric and adult patients: does age matter?[J]. Chin Med J (Engl),2020,133:2422-2428.
[6] Lin AE, Chang YC, Lin MY, et al. Comparison of treatment for congenital nasolacrimal duct obstruction: a systemic review and Meta-analysis[J]. Can J Ophthalmol,2016,51:34-40.
[7] Sathiamoorthi S, Frank RD, Mohney BG. Spontaneous resolution and timing of intervention in congenital nasolacrimal duct obstruction[J]. JAMA Ophthalmol,2018,136:1281-1286.
[8] Asano M, Takeuchi M, Ohno T, et al. Lacrimal sac massage for congenital nasolacrimal duct obstruction: a multicentre randomised controlled trial[J]. Br J Ophthalmol,2024: bjo-2023-324595. doi:10.1136/bjo-2023-324595. Online ahead of print.
[9] 中华医学会眼科学分会眼整形眼眶病学组. 中国先天性鼻泪管阻塞诊疗专家共识[J]. 中华眼科杂志,2021,57:814-818.
[10] 中国妇幼保健协会儿童眼保健专业委员会. 关于婴幼儿泪道相关疾病诊断及治疗的专家共识[J]. 中国斜视与小儿眼科眼科杂志,2021,29:1-4.
[11] Pediatric Eye Disease Investigator Group, Repka MX, Chandler DL, et al. Primary treatment of nasolacrimal duct obstruction with probing in children less than four years old[J]. Ophthalmology,2008,115:577-584.
[12] Hung CH, Chen YC, Lin SL, et al. Nasolacrimal duct probing under topical anesthesia for congenital nasolacri-mal duct obstruction in Taiwan[J]. Pediatr Neonatol,2015,56:402-407.
[13] Świerczyńska M, Tobiczyk E, Rodak P, et al. Success rate of probing for congenital nasolacrimal duct obstruction at various ages[J]. BMC Ophthalmol,2020,20:403. doi:10.1186/s12886-020-01658-9.
[14] Muthumalai M, Alam MS, Shrirao N, et al. A case-control study to determine the microbiological spectrum and antibiotic sensitivity patterns in congenital nasolacrimal duct obstruction[J]. J Curr Ophthalmol,2022,34:251-256.
[15] Kim D, Lew H. Comparison of outcomes of silicone tube intubation with or without dacryoendoscopy for the treatment of congenital nasolacrimal duct obstruction[J]. J Clin Med,2023,12:7370. doi:10.3390/jcm12237370.

年龄因素对先天性鼻泪管阻塞泪道探通术治疗效果的影响

Effect of age on the success rate of lacrimal probing in the congenital nasolacrimal duct obstruction

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