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儿童泪道阻塞性疾病包括膜性与骨性阻塞.我国开展儿童泪道阻塞性疾病治疗已有50余年,从简单的凭临床经验判断,到CT、MRI、造影检查;从泪道冲洗、探通、挂线、插管、鼻腔泪囊吻合(dacryorhinocystostomy,DCR)手术治疗,到鼻腔内窥镜下插管、泪道激光联合插管、鼻腔内窥镜下泪道造孔手术、3D内窥镜下泪道微创手术,逐渐发展到精准、微创、个性化治疗.我国地域辽阔、人口众多,专职的泪道医生仅分布在数个大城市,很多眼科医师缺乏对儿童泪道疾病阶梯治疗理论体系的了解与系统培训.本文就普及儿童泪道阻塞性疾病阶梯治疗的设计与实施进行解读,以期更多眼科医生了解儿童泪道阻塞性疾病的阶梯治疗要略.","Childrens lacrimal duct obstructive diseases include membranous and osseous obstruction.It has been more than 50 years since the initial treatment of childrens lacrimal duct obstructive disease in our country,from the simple clinical experience to the CT,MRI and angiography examination.From lacrimal duct washing,probing,hanging line,intubation,dacryocystorhinostomy to intubation under nasal endoscope,laser combined with intubation under nasal endoscope,sinus surgery under nasal endoscope,minimally invasive surgery under 3D endoscope,gradually to the precision,minimally invasive,personalized treatment.However,the doctors who work full-time for lacrimal duct diseases only distributed in the several domestic big cities in China,many ophthalmologists are lack of understanding and systematic training for the theoretical ladder treatment of pediatric lacrimal duct diseases.In this paper,the steps of the design and implementation of treatment for pediatric lacrimal duct obstructive diseases are elucidated,in the hope of more ophthalmologists slightly understanding the step treatment principles of pediatric lacrimal duct obstructive diseases.