先天性泪囊突出的研究进展

先天性泪囊突出是由于鼻泪管远端(Hasner瓣膜)和近端(Rosenmuller瓣膜)的同时堵塞引起泪囊继发性扩张而形成,典型临床表现为泪囊区皮下青紫色肿物,其与儿童常见先天性泪囊炎有很大区别.此病有自愈倾向,保守治疗有一定疗效,但易引发严重的感染、呼吸窘迫等危及生命的并发症.近来研究倾向于先行保守治疗,无效后再行手术治疗.     

泪囊瘘摘除术治疗先天性泪囊瘘

目的：评估泪囊瘘摘除术治疗先天性泪囊瘘的效果。方法：24例（25眼）确诊为先天性泪囊瘘的儿童进行泪囊瘘摘除术，术后随访6－39月。结果：24例术后无一例出现泪溢症状，治愈率为100％。结论：先天性泪囊瘘可通过单纯泪囊瘘摘除术而治愈。     

泪囊瘘管切除术治疗儿童先天性泪囊瘘

目的评估泪囊瘘管切除术治疗儿童先天性泪囊瘘的效果。方法回顾性分析我院2008年4月至2014年3月采用放大镜下泪囊瘘管切除术治疗的先天性泪囊瘘患儿62例。术后随访3~36个月。结果 62例中男39例,女23例,双眼2例,单眼60例,平均年龄4.5岁。所有患儿瘘管位于内眦部的下方与泪囊或泪总管相连。全部病例均治愈,治愈率为100%。1例术后发生急性泪囊炎,3例术后切口有缝线排异,所有病例术后均无疤痕,无其他并发症发生。结论先天性泪囊瘘可以通过泪囊瘘管切除术治愈。放大镜下泪囊瘘管切除术治疗儿童先天性泪囊瘘简便、安全、效果好。     

先天性泪囊膨出诊断和治疗及病因探讨

目的：回顾性研究我院接诊的先天性泪囊膨出患者,并讨论该类疾病产生的病因和临床处理方案。方法：系统回顾我院2002-01-01/2011-12-31就诊的先天性泪囊膨出患儿共9例10眼,其中男4例4眼,女5例6眼,均在出生后立即发现泪囊区肿块,对所有患者进行全身抗生素使用和局部泪囊冲洗注入抗生素。结果：对经空心泪道探针抽取泪囊内脓液的7眼进行细菌培养,病菌检出率为90%。检出分别是G-菌3株,G＋菌6株。G-菌对左氧氟沙星、环丙沙星最为敏感,G＋菌对左氧氟沙星和妥布霉素最为敏感。细菌对红霉素的敏感性均最低。2眼在以上治疗后采用泪道探通术。结论：先天性泪囊膨出有典型的临床表现,新生儿科及眼科医生可早期发现,多合并胎儿先天性泪道阻塞,多转归成急性泪囊炎,出生后应积极治疗避免并发症出现。     

小儿先天性泪囊炎的手术治疗

小儿先天性泪囊炎临床上比较常见,绝大多数经过挤压、冲洗及泪道探通往往获得满意疗效.对这些方法不能治愈的5例我们施行泪囊鼻腔吻合术获得成功.介绍如下.     

儿童先天性泪囊瘘的手术治疗

先天性泪囊瘘是一种少见的先天性泪道发育异常。关于本病的治疗文献少有报道,自1993年以来,我科共收治有临床症状的儿童先天性泪囊瘘2 0例,手术效果满意,现报告如下。1　临床资料1.1　一般资料　先天性泪囊瘘患儿2 0例2 0眼,其中男16例,女4例,均系足月产儿。右眼11例,左眼9例。     

先天性泪囊炎66例治疗体会

收集我科1990年3月-2006年4月先天性泪囊炎患儿66例，在冲洗出其泪囊内脓液后均施以泪道探通术，效果满意，现报告如下。     

先天性泪囊瘘8例治疗分析

目的：探讨先天性泪囊瘘的治疗方法。方法：对8例（9只眼）先天性泪囊瘘患者行瘘管烧灼联合缝合术治疗。结果：6例患者一次成功,2例患者行再次手术,随访2．2月,全部成功。结论：瘘管烧灼联合缝合术是治疗先天泪囊瘘简单有效的方法。     

Pathology and computed tomography

Although computed tomography (CT) has been an explosive development over the past several years resulting in great improvement in the preoperative localization of orbital tumors and other pathologic processes, it has its limitations in terms of providing specific histologic diagnoses. The cases selected for this presentation illustrate some of these limitations, and some of the lessons learned from our experiences during the past few years.     

Investigation of lacrimal sac space-occupying lesions using color doppler ultrasound, computed tomography, and computed tomography dacryocystography

AIM: To observe the imaging features of color Doppler ultrasound (CDU) and computed tomography (CT) or computed tomography dacryocystography (CT-DCG) in different types of lacrimal sac space-occupying lesions (SOLs). METHODS: This retrospective case series study included 21 patients with lacrimal sac SOLs who underwent lacrimal sac surgery between January 2018 and March 2022. The imaging features of CDU and CT or CT-DCG in these patients were extracted from the examination cloud system. The images were observed and analyzed. RESULTS: The detection rate of lacrimal SOLs between CDU (21/21, 100%) and CT or CT-DCG (20/21, 95.2%) had no statistically significant difference (P=1.0). CDU could detect the blood flow signals in all SOLs except mucocele and mucopeptide concretion. Among them, polyps had characteristic imaging changes on CDU and CT-DCG. The mucoceles and mucopeptide concretions had characteristic imaging changes on CDU, which could provide more information for differential diagnosis. CONCLUSION: The morphology and internal blood flow signals of lacrimal sac SOLs can be observed using CDU. CT or CT-DCG has advantages in observing structural damage around the lacrimal sac mass. Therefore, CDU may be used as a routine examination to exclude lacrimal sac SOLs before dacryocystorhinostomy in the absence of preoperative CT or CT-DCG.     

先天性鼻泪管阻塞CT泪囊造影及骨性鼻泪管测量初步研究

目的分析先天性鼻泪管阻塞患儿CT泪囊造影检查结果,了解其骨性鼻泪管大小。设计回顾性病例系列。研究对象10例单侧先天性鼻泪管阻塞患儿。方法采用CT轴位扫描,矢状位及冠状位二维重建技术,分析10例单侧先天性鼻泪管阻塞患儿CT泪囊造影结果,并测量其双侧骨性鼻泪管直径。主要指标鼻泪管起始处、骨性鼻泪管中段及骨性鼻泪管末端平面的骨性鼻泪管横径。结果 CT可以清晰显示泪囊、鼻泪管及其周围组织。单侧先天性鼻泪管阻塞患儿阻塞侧骨性鼻泪管起始部、中部、远端的直径（5.6±1.1 mm、5.2±0.7 mm、5.8±0.7 mm）明显大于健侧（3.7±0.9 mm3、.6±0.6 mm、3.9±1.2 mm）（P均〈0.05）。结论 CT泪囊造影可以清晰显示泪道及其周围组织情况。单侧先天性鼻泪管阻塞患儿阻塞侧骨性鼻泪管较健侧明显扩大,其发生具体原因尚需要进一步研究。     

Intrathecal metrizamide computed tomography: Diagnosis of downbeat nystagmus in Arnold-Chiari I malformation

Conventional computed tomographic scans are often inadequate for the evaluation of the medullary cervical junction and adjacent cerebellar structures. Visualization of the subarachnoid spaces from the distal tip of the dural spinal canal to the cranial cavity is greatly enhanced by the intrathecal injection of metrizamide. Photographs demonstrate findings with and without metrizamide injection in the case of a 58-year-old patient with Arnold-Chiari I malformation.     

单侧先天性小眼球CT表现（附41例分析）

目的探讨先天性小眼球的CT表现及眼眶容积变化。设计回顾性病例系列。研究对象41例先天性小眼球患者。方法分析41例先天性小眼球患者的影像检查资料。测量其中20例双侧眼眶容积。主要指标眼眶CT影像和双侧眼眶容积。结果41例先天性小眼球均为单侧。其中单纯性小眼球3例,CT表现为眼球前后径减小。缺损性小眼球14例,表现为眼球体积小,眼环局限性缺损,边界清楚的低密度影突出于眼球之外,以视乳头区视神经下方多见。并发性小眼球24例,表现为眼球体积小,玻璃体密度不均匀增高,晶状体缺如、钙化,视网膜脱离,其中伴永存原始玻璃体增生症3例,表现为晶状体后方与视盘之间带状或圆锥状软组织影。单纯性小眼球患侧与健侧平均容积为（11．58±4．77）ml、（13．25±4．45）ml（n=2）;缺损性小眼球患侧与健侧平均容积为（16．06±3．75）ml、（17．92±4．02）ml（n=5）;并发性小眼球患侧与健侧平均容积为（12．61±2．59）ml、（15．89±3．08）ml（n=13）（P均=0．000）.结论CT能够较清楚显示小眼球及伴发的眼部异常,有助于小眼球诊断、分类及治疗。（眼科,2009,18：131-134）     

泪道CT检查的研究进展

泪道CT检查是常用的泪道影像学检查方法之一,在泪道阻塞性疾病诊断和治疗中具有重要作用。近年来,泪道CT检查取得了较大的进展,本文综述了近年来泪道CT检查的仪器设备及检查技术的改进、影像解剖学特点、临床应用及目前存在的尚待解决的问题等。     

Diagnosis of the empty sella with intrathecal metrizamide computed tomography

The empty sella syndrome can be diagnosed with high resolution computed tomography. The addition of intrathecal metrizamide defines the degree of extension of the subarachnoid space into the sella turcica, demonstrates the relationship of surrounding structures, and differentiates the empty sella from other isodense or hypodense intrasellar lesions. Photographs from a case of primary empty sella demonstrate the details of anatomy seen with metrizamide computed tomography combined with sagittal reconstruction.