摘要: 目的：评估刮除手术治疗霰粒肿的临床效果与安全性。方法：回顾性分析我院2026年1月至2026年2月期间，确诊为霰粒肿并接受手术治疗的174例患儿的临床资料。记录手术时间、术后创口愈合情况、术后1周、1个月、3个月的治愈率、复发率及并发症发生情况。结果：174例患者手术均顺利完成，主要并发症包括局部皮下瘀血2例、出血5例以及眼睑水肿30例，去重后约35例；有感染史患儿68例，发生并发症22例(32.4%)；无感染史患儿106例，并发症13例(12.3%)，两组比较差异有统计学意义(
χ2 = 6.7, P = 0.010)，提示术前合并感染史者术后早期并发症风险显著升高；合并感染(OR = 3.2, 95% CI: 1.5~6.8, P = 0.002)和病灶直径 > 10 mm (OR = 2.8, 95% CI: 1.26.4, P = 0.015)是术后需二次手术复发的独立危险因素；年龄 > 6岁(OR = 0.5, 95% CI: 0.3~0.9, P = 0.040)与复发风险降低显著相关，提示年龄 ≤ 6岁的低龄患儿复发风险更高。而下睑与上睑相比，复发风险差异无统计学意义(OR = 0.7, 95% CI: 0.3~2.0, P = 0.517)。术后1周治愈率为47%，1个月为80%，3个月为100%。术后均恢复良好，外观满意。未出现严重感染或眼睑内外翻、缺损畸形。结论：霰粒肿保守治疗效果不佳的患儿，应及时给予手术治疗。手术治疗霰粒肿疗效确切，治愈率高，复发率低，操作相对安全。对于巨大霰粒肿、局部肉芽增生、多发性霰粒肿的患儿是理想的治疗选择。合并感染患儿术后更易出血、眼睑水肿以及二次手术；低龄、病灶较大亦是霰粒肿复发的危险因素。
Abstract: Objective: To evaluate the clinical efficacy and safety of curettage for the treatment of chalazia. Methods: A retrospective analysis was conducted on the clinical data of 174 pediatric patients diagnosed with chalazia and treated surgically at our hospital between February and March 2026. We recorded the duration of surgery, postoperative wound healing, cure rates at 1 week, 1 month and 3 months postoperatively, recurrence rates, and the incidence of complications. Results: All 174 surgeries were completed successfully. The average duration of surgery was 15 minutes, and wounds healed on average 6.5 days postoperatively. The cure rate was 47% at 1 week postoperatively, 80% at 1 month, and 100% at 3 months. Reoperation was performed in 30 cases: 14 children underwent surgery for a meibomian gland cyst in the contralateral eyelid during follow-up, and 24 children underwent surgery for a meibomian gland cyst in a different location of the same eye. All patients recovered well postoperatively with satisfactory cosmetic results. Major complications included 2 cases of postoperative local subcutaneous hematoma and 30 cases of temporary eyelid edema; no severe infections, eyelid entropion or ectropion, or deformities were observed. All 174 patients underwent successful surgery. Major complications included local subcutaneous hematoma in 2 cases, bleeding in 5 cases, and eyelid edema in 30 cases (approximately 35 cases after deduplication); Among the 68 children with a history of infection, 22 (32.4%) developed complications; among the 106 children without a history of infection, 13 (12.3%) developed complications. The difference between the two groups was statistically significant (χ2 = 6.7, P = 0.010), suggesting that patients with a history of preoperative infection had a significantly higher risk of early postoperative complications; Concomitant infection (OR = 3.2, 95% CI: 1.5~6.8, P = 0.002) and lesion diameter > 10 mm (OR = 2.8, 95% CI: 1.2~6.4, P = 0.015) were independent risk factors for recurrence requiring a second surgery; age > 6 years (OR = 0.5, 95% CI: 0.3~0.9, P = 0.040) was significantly associated with a reduced risk of recurrence, suggesting that younger patients aged ≤ 6 years have a higher risk of recurrence. In contrast, there was no statistically significant difference in recurrence risk between the lower and upper eyelids (OR = 0.7, 95% CI: 0.3~2.0, P = 0.517). The cure rate was 47% at 1 week postoperatively, 80% at 1 month, and 100% at 3 months. All patients recovered well postoperatively, and cosmetic outcomes were satisfactory. No cases of severe infection, eyelid entropion or ectropion, or deformities due to tissue defects were observed. Translated with DeepL.com (free version). Conclusion: Children with chalazia that do not respond well to conservative treatment should undergo prompt surgical intervention. Surgical treatment of chalazia is effective, with a high cure rate, low recurrence rate, and is relatively safe. It is the ideal treatment option for children with giant chalazia, localized granulation tissue proliferation, or multiple chalazia. Children with concurrent infections are more prone to postoperative bleeding, eyelid swelling, and the need for a second surgery; younger age and larger lesions are also risk factors for chalazion recurrence.