摘要
目的:探讨强脉冲光(IPL)治疗儿童霰粒肿的临床疗效。方法:收集2022年12月至2023年3月于郑州大学第一附属医院眼科干眼中心就诊并诊断为特发性霰粒肿并进行IPL治疗的患病儿童共21例(33只眼)进行研究。其中，男性8例(13只眼)，女性13例(20只眼)。年龄为2~12岁，平均年龄(4.0±2.3)岁。全部患者进行眼周的IPL治疗。霰粒肿治疗结果的判定标准分为三级。治愈，霰粒肿消退；好转，霰粒肿缩小；无效，霰粒肿大小不变。参考治疗前后眼前段照相及电话回访时患儿家长的真实描述，收集全部患者就诊的病例资料，记录患者的性别、年龄、眼别、霰粒肿的患病时间、霰粒肿的部位、霰粒肿的大小及治疗结果。以上数据均采用例数(眼数)及百分比进行描述。结果:全部患者21例(33只眼)均进行了眼周强脉冲光治疗。其中，治疗结果为治愈的共有13例(20只眼)，占60.6%；治疗结果为好转的共有8例(13只眼)，占39.4%；治疗结果为无效的共有0例(0只眼)，占0.0%。全部患者21例(33只眼)中，治疗前霰粒肿患病时间<4周者共计5例(10只眼)，占30.30%。其中，治疗结果为治愈的有2例(4只眼)，占40.0%(4/10)；治疗结果为好转的有3例(6只眼)，占60.0%(6/10)；治疗结果为无效的有0例(0只眼)，占0.0%(0/10)。治疗前霰粒肿患病时间≥4周且<8周者，共13例(19只眼)，占57.58%。其中，治疗结果为治愈的有10例(15只眼)，占78.9%(15/19)；治疗结果为好转的有3例(4只眼)，占21.1%(4/19)；治疗结果为无效的有0例(0只眼)，占0.0%(0/19)。治疗前霰粒肿患病时间≥8周者，共3例(4只眼)，占12.12%。其中，治疗结果为治愈的有1例(1只眼)，占25.0%(1/4)；治疗结果为好转的有2例(3只眼)，占75.0%(3/4)；治疗结果为无效的有0例(0只眼)，占0.0%(0/4)。全部患者21例(33只眼)中，霰粒肿类型为皮肤面型者有8例(13只眼)，占39.39%。其中，治疗结果为治愈的有6例(10只眼)，占76.9%(10/13)；治疗结果为好转的有2例(3只眼)，占23.1%(3/13)；治疗结果为无效的有0例(0只眼)，占0.0%(0/13)。霰粒肿类型为结膜面型者有12例(18只眼)，占54.55%。其中，治疗结果为治愈的有7例(10只眼)，占55.6%(10/18)；治疗结果为好转的有4例(8只眼)，占44.4%(8/18)；治疗结果为无效的有0例(0只眼)，占0.0%(0/18)。霰粒肿类型为近睑缘型者2例(2只眼)，占6.06%。其中，治疗结果为治愈的有0例(0只眼)，占0.0%(0/2)；治疗结果为好转的有2例(2只眼)，占100.0%(2/2)；治疗结果为无效的有0例(0只眼)，占0.0%(0/2)。结论:强脉冲光在儿童霰粒肿的治疗中疗效确切；皮肤面型霰粒肿较结膜面型治愈率更高；治疗前霰粒肿患病时间≥4周且<8周者，治愈率更高，未观察到IPL治疗过程中患者严重的不良反应。
Abstract
Objective:To explore the clinical efficacy of intense pulsed light (IPL) in the treatment of chalazion in children.Methods:A total of 21 children (33 eyes) with idiopathic chalazion diagnosed and treated with IPL in the Dry Eye Center of the First Affiliated Hospital of Zhengzhou University from December 2022 to March 2023 were collected. Among them, there were 8 males (13 eyes) and 13 females (20 eyes) with an average age of (4.0±2.3) years (ranged from 2 to 12 years). All patients were treated with IPL around the eyes, and referred to before and after the treatment and follow-up phone call for patients′ parents, the real description was obtained. The treatment results of chalazion were graded as follows: cure (chalazion subsided), improvement (chalazion reduction), invalid (no change). The base information of patients′gender, age, eye type, the onset time of chalazion, the location of chalazion, the size of chalazion and the treatment results were recorded. Data was described by the number of cases (eyes) and percentage.Results:All 21 patients (33 eyes) underwent IPL treatment. There were 13 cases (20 eyes) with cure, 8 cases (13 eyes) with improvement, 0 (0 eyes) with invalid, accounting for 60.6%, 39.4% and 0.0%, respectively. Among patients with chalazion, 5 patients (10 eyes) had a history of chalazion for less than <4 weeks before treatment, accounting for 30.30%. Among them, there were 2 cases (4 eyes) with cure, 3 cases (6 eyes) with improvement, 0 case (0 eye) with invalid, accounting for 40.0% (4/10), 60.0% (6/10), 0.0% (0/10), respectively. There were 13 cases (19 eyes) with a history of chalazion for ≥4 weeks and <8 weeks before treatment, accounting for 57.58%. Among them, there were 10 cases (15 eyes) with cure, 3 cases (4 eyes) with improvement, 0 case (0 eye) with invalid, accounting for 78.9% (15/19), 21.1% (4/19), 0.0% (0/19), respectively. Before treatment, 3 cases (4 eyes) had chalazion for ≥8 weeks, accounting for 12.12%. Among them, there were 1 case (1 eye) with cure, 2 cases (3 eyes) with improvement, 0 case (0 eye) with invalid, accounting for 25.0% (1/4), 75.0% (3/4), 0.0% (0/4), respectively. Of the 21 patients (33 eyes) with chalazion, 8 patients (13 eyes) with skin-type chalazion, accounting for 39.39%. Among them, there were 6 cases (10 eyes) with cure, 2 cases (3 eyes) with improvement, 0 case (0 eye) with invalid, accounting for 76.9% (10/13), 23.1% (3/13), 0.0% (0/13), respectively. There were 12 cases (18 eyes) of chalazion type on the conjunctival surface, accounting for 54.55%. Among them, there were 7 cases (10 eyes) with cure, 4 cases (8 eyes) with improvement, 0 case (0 eye) with invalid, accounting for 55.6% (10/18), 44.4% (8/18), 0.0% (0/18), respectively. There were 2 cases (2 eyes) of chalazion type near the eyelid margin, accounting for 6.06%. Among them, there were 0 case (0 eye) with cure, 2 cases (2 eyes) with improvement, 0 case (0 eye) with invalid, accounting for 0.0% (0/2), 100.0% (2/2) and 0.0% (0/2).Conclusions:IPL has a definite therapeutic effect in the treatment of chalazion in children. The cure rate of chalazion on the skin surface is higher than that on the conjunctiva surface. Patients with chalazion for ≥4 weeks and <8 weeks before treatment have a higher cure rate, and no serious adverse reactions were observed during the IPL treatment.
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