泪点栓或泪小管栓置入后继发泪小管炎的临床诊治

发布时间：2018-05-13 06:03

本文选题：泪点栓 + 泪小管栓　；参考：《眼科新进展》2014年03期

【摘要】：目的探索泪点栓和泪小管栓置入后继发泪小管炎的诊治方法及效果。方法回顾性分析置入泪点栓和泪小管栓后继发泪小管炎的4例(7眼8根泪小管)患者的临床资料,对其临床特点、检查方法、治疗方法及效果进行分析。结果 4例患者均为女性,8根泪小管中下泪小管有5根。置入泪道栓后继发泪小管炎的时间平均为36个月。8根泪小管的泪点及旁区均有不同程度红肿,均可见奶昔样黏脓性分泌物自泪点溢出。7眼患者尝味试验阳性率100%。泪道CT造影检查结果显示,7眼泪道(鼻泪管)通畅率100%,注入造影剂的7根泪小管中3根泪小管内可见中高密度影,泪小管显影率43%。6根泪小管行UBM检查结果显示,均可见形态特异的高回声影,阳性率100%。泪道内窥镜探查8根泪小管,异物发现率100%。其中2根泪小管最终给予泪道内窥镜下栓子冲洗排出术+人工泪小管置入术,2根泪小管给予泪道内窥镜下栓子冲洗排出术,另4根泪小管给予泪小管切开、栓子取出+人工泪小管置入术,泪小管切开率50%,泪道栓取出率100%。术前行UBM检查的6根泪小管,术中所见泪道栓子位置及形态与UBM检查一致率100%。2根泪小管中的2枚泪道栓位置与CT显影结果基本一致。结论泪道UBM检查能够较准确地显示泪道栓子在泪小管内存留的位置。采用泪小管切开、栓子取出并人工泪小管置入术治疗泪点栓或泪小管栓置入后继发泪小管炎均可获得良好效果。
[Abstract]:Objective to explore the diagnosis and treatment of lacrimal tubulitis secondary to lacrimal tubulitis after lacrimal dot embolus and lacrimal tubule embolus implantation. Methods the clinical data of 4 patients with lacrimal tubulitis secondary to lacrimal tubulitis after placement of lacrimal dot embolus and lacrimal tubule embolus were analyzed retrospectively. The clinical features, examination methods, treatment methods and results were analyzed. Results five of the 8 lacrimal canaliculi were female. After placement of lacrimal duct suppository, the average time of secondary lacrimal tubulitis was 36 months. The lacrimal point and paracentral area of the lacrimal tubules had different degrees of redness and swelling. The positive rate of taste test was 100% in all the patients with milkshake mucopulmonary discharge from the lacrimal point of 7. 7 eyes. The results of CT examination of lacrimal duct showed that the patency rate of lacrimal duct (nasolacrimal duct) was 100. 3 of the 7 lacrimal canaliculi injected with contrast media showed moderate and high density, and the lacrimal canaliculus showed 43.6% of the lacrimal canaliculus by UBM. The positive rate was 100%. Lacrimal duct endoscopic exploration of 8 lacrimal canaliculi, foreign body detection rate 100. Two lacrimal canaliculi were treated with endoscope embolus irrigation and drainage. Two lacrimal canaliculi were treated with lacrimal duct endoscope and the other 4 lacrimal canaliculi were treated with lacrimal canaliculi incision. Embolus removal artificial lacrimal canaliculus implantation, lacrimal canaliculus incision rate 50, lacrimal duct plug removal rate 100. Six lacrimal canaliculi were examined by UBM before operation. The position and shape of lacrimal duct embolus were consistent with those of UBM examination. The location of two lacrimal duct emboli in 100.2 lacrimal canaliculi was basically consistent with CT findings. Conclusion lacrimal duct UBM can accurately display the location of lacrimal duct embolus in lacrimal ducts. Using lacrimal canaliculi incision, embolus removal and artificial lacrimal canaliculus implantation for the treatment of lacrimal tubulitis secondary to lacrimal tubulitis can obtain good results.
【作者单位】：中国武警总医院眼科泪器病中心;
【分类号】：R779.6

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