目的：对比全身麻醉与局部麻醉下进行儿童霰粒肿切除术的综合疗效。

方法：回顾性病例对照研究。将2015-01/2016-12在我院接受霰粒肿切除手术的双眼霰粒肿患儿(4～10周岁)，根据采用的麻醉方法分为两组：全身麻醉组(全麻组，67例134眼)和局部麻醉组(局麻组，72例144眼)。分析两组患者的疼痛及术后心理创伤，以及术后1mo眼表健康状况、术后1a内复发率和并发症等四个方面的差异。

结果：全麻组和局麻组患儿均未出现麻醉相关并发症和意外。全麻组患儿术中不存在疼痛，术后3h的面部表情疼痛量表(FPS-R)值为4.94±1.23分，低于局麻组(7.00±1.14分)，差异有统计学意义(P<0.001)。全麻组患儿有12例出现再次就医回避，局麻组为35例，差异有统计学意义(P<0.01)。全麻组的泪膜破裂时间、泪膜脂质层厚度和泪河高度均高于局麻组，差异有统计学意义(P<0.001)； 其睑脂性状评分也低于局麻组，差异有统计学意义(P<0.01)。全麻组患儿囊肿复发率为6.0%，低于局麻组的20.8%，差异有统计学意义(P<0.05)。全麻组患儿出现并发症发生率为4.5%，局麻组为15.3%，差异有统计学意义(P<0.05)。

结论：全身麻醉下进行儿童霰粒肿手术具有术后疼痛轻、患儿依从性好的基本优点。与局部麻醉下手术相比，全身麻醉术中能够进行精细操作，术后眼表健康情况更好，并发症更少。

METHODS: This was a retrospective case-control study. Pediatric patients(4-year-old to 10-year-old)with bilateral chalazion who were treated with extraction surgery were included during January 2015 to December 2016. These subjects were divided into two groups according to type of anesthesia: general anesthesia group(GA group, 67 cases, 134 eyes)and local anesthesia group(LA group, 72 cases, 144 eyes). The pain score(FPS-R)and post-operative psychological destruction scores, condition of tear film and Meibomian gland, the recurrent rate and postoperative complications were recorded and statistically analyzed.

RESULTS: No anesthesia-associated complication were recorded in both groups. The children in GA group felt no pain during operations. The FPS-R score at 3h after surgery in GA group was 4.94SymbolqB@1.23, which was significantly lower than that of LA group(7.00SymbolqB@1.14, P<0.001). And 12 cases in GA group showed resistance to re-examination at hospital, while 35 cases showed resistance in LA group(P<0.01). The tear break-up time, tear meniscus height and lipid layer thickness were higher than those in LA group(P<0.001), while the meibum score were significantly lower(P<0.01). The recurrent rate of chalazion was 6.0% in GA group and 20.8% in LA group(P<0.05). The rate of post-operative complications reached 15.3% in LA group, while only 4.5% in GA group(P<0.05).

CONCLUSION: Chalazion surgery under general anesthesia has the advantage of mild pain and good compliance in children. After surgery, the patients presented with better tear film and Meibomian gland status, and fewer complications under general anesthesia.