4세 이하의 선천성 코눈물관막힘 환아에서 외래에서 시행한 코눈물관탐침술 임상결과 분석
Analysis of Office Probing in Children Under 4 Years of Age with Congenital Nasolacrimal Duct Obstruction
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목적: 4세 이하 선천성 코눈물관막힘 환아에서 나이에 따른 코눈물관탐침술의 효과를 분석하고자 한다. 대상과 방법: 선천성 코눈물관막힘으로 진단받고 코눈물관탐침술을 시행한 환아 146명(200안)을 대상으로 후향적 연구를 실시하였다. 연령에 따라서 A군(6개월 이하), B군(6개월 초과 12개월 이하), C군(12개월 초과 20개월 이하), D군(20개월 초과 48개월 이하)으로 분류하여 시술 당시의 나이, 성별, 시술의 양측성 여부, 경과 관찰 기간, 임상증상을 조사하고, 각 군별 양측성 여부, 탐침술의 횟수에따른 코눈물관탐침술의 성공률을 비교 분석하였다. 결과: 첫 번째 탐침술의 성공률은 160/200안(80.0%), 연령별로 A군에서 87.5%, B군에서 85.7%, C군에서 77.6%, D군에서 76.7%로 확인되었으며, 각 군별 성공률은 유의한 차이가 없었다(p=0.550). 두 번째 탐침술은 총 40안에서 시행하였으며, 성공률은 25/40안(62.5%)이었다. A군에서 100%, B 군에서 87.5%, C군에서 70.6%, D군에서 35.7%로 확인되었으며, 각 군별 성공률은 유의한 차이가 있었다(p=0.048). 시술의 편측성 여부에 따른 각 군별 탐침술의 성공률은 통계학적으로 유의한 차이가 없었다(p=0.291). 결론: 4세 이하의 환아에서 나이에 따른 첫 번째 코눈물관탐침술의 성공률에는 유의한 차이가 없었지만, 두 번째 코눈물관탐침술은 나이에 따른 성공률의 차이가 있었으며, 특히 20개월 이상에서 재시술 성공률은 감소하였다.
Abstract
Purpose: To analyze the effect of office-based probing in different age groups of children with congenital nasolacrimal duct obstruction. Method: A retrospective study was conducted in 146 children (200 eyes) diagnosed with congenital nasolacrimal duct obstruction who underwent office-based probing. The children were classified into four groups at the time of probing: group A (< 6 months), group B (> 6 months but < 12 months), group C (> 12 months but < 20 months), and group D (> 20 months but < 48 months). Age at the time of the procedure, gender, laterality, follow-up period, clinical symptoms, and the number of probings were investigated. Success rates were compared among the four groups in terms of sex, age, laterality, and the number of probings. Results: The success rate of the first probing was 160/200 eyes (80.0%). The success rates were 87.5% in group A, 85.7% in group B, 77.6% in group C, and 76.7% in group D. No significant difference in the success rate was observed according to age (p = 0.550). The second probing was performed in 40 eyes. The success rates were 100% in group A, 87.5% in group B, 70.6% in group C, and 35.7% in group D. A significant difference in the success rate was observed according to age (p = 0.048). The success rate of the second probing was 25/40 eyes (62.5%). No significant difference in laterality was observed among the four groups (p = 0.291). Conclusions: No significant difference in the success rate of first nasolacrimal duct probing was detected, but a significant difference in the success rate of the second probing was detected according to age in children < 4 years of age.
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