Ritleng 泪道插管术治疗结膜炎导致的儿童继发性泪道阻塞疗效观察

目的：探讨 Ritleng 泪道插管术治疗儿童结膜炎继发泪道阻塞的疗效。方法回顾性分析因结膜炎导致继发性泪道阻塞的患儿39例（42只眼）。所有患儿均行 Ritleng 泪道插管术，术后3-6个月拔管，并在拔管后1个月进行随访。以泪道冲洗和 DDT 检查结果最终确定其术后效果。结果患儿39例（42眼）成功置管，拔管后30眼治愈（71％）：泪道冲洗通畅，无流泪症状，DDT 试验阴性；4眼（10％）好转：患儿偶有流泪症状，泪道冲洗存在阻力，DDT 可疑阳性；8眼（19％）无效：拔管后，冲洗泪道不通畅，仍有分泌物、有流泪症状。DDT 阳性。所有患儿42只眼中，共14眼单纯性阻塞，包括4眼为泪小点闭锁；泪小管阻塞为6眼；鼻泪管阻塞有4眼。单纯性阻塞中12眼治愈；1眼好转、1眼无效；共28眼复杂性阻塞，其中18眼治愈，3眼好转，7眼无效。结论对于结膜炎引起的儿童泪道阻塞，Ritleng 泪道插管术存在一定效果，通过该手术可以减少由于未及时手术治疗而出现的不利因素，提高手术成功率。

Ritleng lacrimal intubation applied in children with acquired nasolacrimal duct obstruction

Objective This study evaluates the clinical efficacy of silicone intubation using the Ritleng method in children with acquired nasolacrimal duct obstruction （NLDO） after conjunctivitis. Methods In this study, we reviewed 39 cases （42 eyes） of acquired nasolacrimal duct obstruction secondary to conjunctivitis. The Ritleng method was used for lacrimal intubation in all of 42 eyes. The silicone tubes were removed after 3 to 6 months. One month later, children were followed up. we evaluated the effectiveness of the operation by dye disappeamnce test （DDT） and nasolacrimal duct irrigation. Results 42 eyes of 39 patients were placed siliconeduct successfully. 30 eyes （71%） were cured （dacryorrhea disappeared, lacrimal patency, DDT-） ;4 eyes were improved （lacrimal patency with some resistance and sometimes tearing, DDT＆#177;） , and 8 eyes were ineffective （lacrimal was not smooth and tearing a-gain, DDT﹢） . 14 eyes in all of 42 eyes were simple obstruction： atresia of puncta were found in 4 eyes, obstruction of canaliculi were found in 6 cases, distal nasolacrimal duct obstruction were found in 4 cases. At last, 12 eyes were suc-cessful, 1 was improved, 1 was ineffective. Another 28 eyes are complicated obstruction： 18 successful, 3 improved and 7 ineffective. Conclusions Silicone intubations with the Ritleng intubation system for acquired nasolacrimal duct ob-struction of children is an easy procedure that yields a efficient rate of success.Negative factors of the delayed operation are reduced.