患了霰粒腫(zhong)是否必須手術(shu)治療(liao)？不進行手術(shu)有(you)什么不良后果(guo)呢(ni)？這是不少家長關心(xin)的(de)問題。
霰粒(li)腫(zhong)(zhong)(zhong)(zhong)(zhong)初起雖(sui)沒(mei)有(you)什(shen)么癥狀(zhuang)，但是不(bu)采取(qu)積(ji)極(ji)的(de)(de)治(zhi)(zhi)療(liao)，囊(nang)(nang)腫(zhong)(zhong)(zhong)(zhong)(zhong)發(fa)(fa)展到(dao)一定程度會自行(xing)破潰，在局部長出像肉芽樣的(de)(de)組(zu)織，醫學(xue)上稱為肉芽腫(zhong)(zhong)(zhong)(zhong)(zhong)。向眼(yan)(yan)(yan)(yan)瞼(jian)內破潰形成的(de)(de)肉芽腫(zhong)(zhong)(zhong)(zhong)(zhong)，常使(shi)眼(yan)(yan)(yan)(yan)球有(you)磨(mo)擦感；向皮膚面破潰的(de)(de)將遺留(liu)瘢痕，甚至造成畸形，如(ru)瞼(jian)外(wai)翻，也就是瞼(jian)緣(yuan)向外(wai)翻轉，離開了(le)眼(yan)(yan)(yan)(yan)球。因此(ci)，大(da)多(duo)(duo)數霰粒(li)腫(zhong)(zhong)(zhong)(zhong)(zhong)需(xu)要(yao)手(shou)術(shu)治(zhi)(zhi)療(liao)，但如(ru)果(guo)囊(nang)(nang)腫(zhong)(zhong)(zhong)(zhong)(zhong)很小或(huo)病程不(bu)長，也可(ke)(ke)(ke)先進(jin)(jin)行(xing)保守治(zhi)(zhi)療(liao)，觀(guan)察病情發(fa)(fa)展。治(zhi)(zhi)療(liao)時多(duo)(duo)在患處涂白降錄或(huo)黃降錄眼(yan)(yan)(yan)(yan)膏，每日(ri)1～2次。白降錄有(you)增加局部血液循環(huan)，促進(jin)(jin)囊(nang)(nang)腫(zhong)(zhong)(zhong)(zhong)(zhong)吸(xi)收(shou)的(de)(de)作(zuo)用。患兒(er)(er)能配(pei)合的(de)(de)話，涂藥(yao)后(hou)可(ke)(ke)(ke)輔助采用熱敷或(huo)眼(yan)(yan)(yan)(yan)球按摩(mo)，以增加療(liao)效。眼(yan)(yan)(yan)(yan)球按摩(mo)的(de)(de)方法是，讓患兒(er)(er)輕(qing)輕(qing)閉(bi)上眼(yan)(yan)(yan)(yan)睛，家長用食指(zhi)或(huo)中指(zhi)尖在眼(yan)(yan)(yan)(yan)睛表(biao)面作(zuo)環(huan)形轉動(dong)，時間(jian)約1分鐘(zhong)。按摩(mo)時動(dong)作(zuo)要(yao)輕(qing)柔。保守治(zhi)(zhi)療(liao)數日(ri)后(hou)，如(ru)囊(nang)(nang)腫(zhong)(zhong)(zhong)(zhong)(zhong)不(bu)見消(xiao)退或(huo)最(zui)初發(fa)(fa)現(xian)時霰粒(li)腫(zhong)(zhong)(zhong)(zhong)(zhong)就很大(da)，則(ze)應進(jin)(jin)行(xing)手(shou)術(shu)刮除(chu)(chu)。霰粒(li)腫(zhong)(zhong)(zhong)(zhong)(zhong)刮除(chu)(chu)術(shu)屬(shu)于(yu)眼(yan)(yan)(yan)(yan)科(ke)的(de)(de)門診小手(shou)術(shu)，在局部麻(ma)醉條件下即(ji)可(ke)(ke)(ke)順(shun)利完成。手(shou)術(shu)時在眼(yan)(yan)(yan)(yan)瞼(jian)內作(zuo)與瞼(jian)緣(yuan)垂直的(de)(de)切口，將囊(nang)(nang)腫(zhong)(zhong)(zhong)(zhong)(zhong)內容物(wu)刮凈。切口不(bu)需(xu)縫(feng)合，手(shou)術(shu)后(hou)涂抗(kang)生素，如(ru)金(jin)霉素，進(jin)(jin)行(xing)壓迫(po)包扎，隔(ge)日(ri)即(ji)可(ke)(ke)(ke)除(chu)(chu)去。
如(ru)果霰粒(li)腫(zhong)(zhong)繼(ji)發感染，也就(jiu)是患(huan)炎(yan)性(xing)霰粒(li)腫(zhong)(zhong)時應該(gai)怎(zen)么(me)辦呢？首(shou)先要(yao)進(jin)行(xing)抗炎(yan)治療，局部用消炎(yan)眼(yan)藥，如(ru)利福平、托白士、金霉素等，有(you)膿(nong)腫(zhong)(zhong)形(xing)成時要(yao)及時切開引(yin)流。待炎(yan)癥消退后(hou)再行(xing)手術治療。有(you)些(xie)家長錯誤地認為炎(yan)性(xing)霰粒(li)腫(zhong)(zhong)就(jiu)是麥(mai)粒(li)腫(zhong)(zhong)，切開引(yin)流后(hou)治療就(jiu)結(jie)束(shu)了(le)，而不繼(ji)續就(jiu)醫，從而延誤了(le)手術時機。臨床上這樣(yang)的教訓并不少見，應引(yin)起家長的注意。
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