泪道的超声显像及生理测值研究

发布时间：2018-07-25 09:09

【摘要】： 目的探讨泪道的正常超声表现及其各径线的超声生理测值,以期能提供泪道疾病的超声诊断依据。方法应用高频超声对235例成人左右侧泪道进行检查,仰卧位,两眼微闭,眼窝部以耦合剂填充,减少眼角凹陷与探头间的间隙。对左右侧泪囊分别横向扫查,在显示最大横切面时,测量内外侧壁间距离作为泪囊最大左右径；旋转探头,显示泪囊纵切面,分别测量泪囊顶部至下端、前后侧壁间距离作为最大长径、前后径,同时测量泪囊壁厚度。在泪囊纵切面略移探头,探及泪囊上端的泪小管,测其内径。在超声显示左右侧泪小管、泪囊和鼻泪管的基础上,分别观察和比较左右泪道各部的超声表现、显示率及其生理测值,并对各组间相应数据进行统计学分析。结果(1)得出泪道各部的显示率：其中以泪囊显示率最高,泪小管的显示率相对低,鼻泪管显示率极低。成人左右泪囊的显示率分别为91.9%和93.6%,左右泪小管显示率均为14.9%,左右鼻泪管显示率则为0.4%和0%。(2)确定左右泪道各部的测值,得出各组间的统计学分析结果：同性别间各测值比较,左侧泪囊长径大于右侧(P0.01)；不同性别间各测值比较,男性双侧泪囊长径大于女性(P0.05),前后径亦大于女性(P0.01)。(3)观察泪道超声声像图：泪道为低或无回声区,呈管形、圆形或椭圆形。结论超声不但能获得满意的泪囊声像,还可显示部分泪小管,并可观察到鼻泪管的最上端。超声可以清晰显示泪囊的相应结构,而泪小管因其腔小壁薄,伸缩性强,不易显示其完整形态,显示率相对低,鼻泪管因超声难以穿透其骨性结构而较难显示。研究泪道声像图表现及其正常测值将有助于泪道疾病的超声诊断。
[Abstract]:Objective to study the normal ultrasonographic manifestation of lacrimal duct and the ultrasonic physiological value of each diameter in order to provide the ultrasonic diagnosis basis for lacrimal duct disease. Methods 235 cases of adult lacrimal duct were examined by high frequency ultrasound. The lacrimal duct was supine, two eyes were microclosed, and the socket was filled with coupling agent to reduce the gap between the angle depression and the probe. The left and right dacryocysts were scanned laterally. The distance between the lateral wall and the lateral wall was measured as the maximum left and right diameter of the dacryocyst, the longitudinal section of the dacryocyst was displayed by rotating probe, and the top of the dacryocyst was measured from the top to the lower end of the dacryocyst. The distance between the anteroposterior and lateral walls was regarded as the maximum length and the anteroposterior diameter, and the thickness of the dacryocyst wall was measured. The probe was slightly shifted on the longitudinal section of the dacryocyst, and the inner diameter of the lacrimal canaliculus was measured at the upper end of the dacryocyst. On the basis of the left and right lacrimal canaliculus, lacrimal sac and nasolacrimal duct, the sonographic manifestations, the display rate and the physiological values of the left and right lacrimal duct were observed and compared respectively, and the corresponding data were analyzed statistically. Results (1) the display rate of lacrimal duct was the highest in lacrimal sac, low in lacrimal duct and extremely low in nasolacrimal duct. The display rates of left and right lacrimal sac in adults were 91.9% and 93.6%, respectively. The display rates of left and right lacrimal canals were 14.9% and 0.4% and 0%, respectively. (2) the values of left and right lacrimal duct were determined, and the results of statistical analysis were obtained. The length diameter of left lacrimal sac was larger than that of right side (P0.01), the length of male dacryocyst was larger than that of female (P0.05), and the anterior and posterior diameter of male dacryocyst was larger than that of female (P0.01). (3). Conclusion Ultrasound can not only obtain satisfactory image of lacrimal sac, but also display part of lacrimal canaliculus and observe the upper end of nasolacrimal duct. The corresponding structure of lacrimal sac could be clearly displayed by ultrasound, while the lacrimal tubule was difficult to display because of its thin wall, strong extensibility, not easy to display its complete shape and relatively low display rate, and the nasolacrimal duct was difficult to display because of the difficulty in penetrating the bone structure of lacrimal duct by ultrasound. The study of lacrimal duct sonogram and its normal value will be helpful to the diagnosis of lacrimal duct disease.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R77

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