丝裂霉素C在泪囊鼻腔吻合术中的应用

目的 :探讨丝裂霉素C(mitomycinC ,MMC)对泪囊鼻腔吻合术的效果。方法 :将 92例 1 0 5只眼慢性泪囊炎随机分为MMC组 4 8例 55只眼和对照组 4 4例 50只眼 ,MMC组术中应用 0 4mg/mlMMC ,对照组未用MMC ,术后平均随访 2 9个月。结果 :手术成功率 :MMC组为 98 0 8% ,对照组为82 61 % (P <0 0 5)。吻合口开通率 :MMC组为 1 0 0 % ,对照组为 82 61 % (P <0 0 1 )。前后瓣膜愈合时间 :MMC组为 7 86± 2 75天 ,对照组为 7 2 2± 2 2 3天 (P >0 0 5)。吻合口出血发生率 :MMC组为3 62 % ,对照组为 2 %。结论 :MMC可作为治疗慢性泪囊炎的一种安全、简单、有效的辅助药物 ,明显提高手术成功率     

丝裂霉素C在泪囊鼻腔吻合术中的应用

目的　为明确丝裂霉素C在泪囊鼻腔吻合术后 ,抗吻合口瘢痕形成至吻合口关闭的作用。方法　将 45例 (47眼 )慢性泪囊炎随机分为MMC治疗组 2 5眼和对照组 2 2眼。MMC组在泪囊鼻腔吻合术中一次性使用 0 4mg/ml的MMC ,对照组不使用MMC。术后随访 6～ 1 2月。结果　MMC治疗组成功率为 1 0 0 % ,对照组为 86 36% (P <0 0 1 )。MMC治疗组术后未出现粘膜坏死、溃疡、眼球损伤或持久性疼痛等并发症。结论　MMC的抗瘢痕作用有助于保持泪囊鼻腔吻合术的骨孔面积 ,促进吻合口通畅。     

丝裂霉素C在泪囊鼻腔吻合术中的应用

目的:观察丝裂霉素C(MMC)在泪囊鼻腔吻合术后,抗吻合口瘢痕形成以及吻合口关闭的作用。方法:将34例(34眼)慢性泪囊炎随机分为MMC治疗组20眼和对照组14眼。MMC组在泪囊鼻腔吻合术中一次性使用0.4g/L的MMC5min,对照组不使用MMC,采用传统泪囊鼻腔吻合术。术后随访6～12mo。结果:MMC治疗组成功率为95%,对照组为86%(P <0.01)。MMC治疗组术后未出现鼻腔粘膜坏死、溃疡、眼球损害等并发症。结论:泪囊鼻腔吻合术中应用MMC安全有效。     

透明质酸钠在鼻腔泪囊吻合术中的应用

目的:探讨透明质酸钠在鼻腔泪囊吻合术中的作用及治疗效果。方法:选自我院2000-02/2008-02收治的慢性泪囊炎患者68例68眼,男16例16眼,女52例52眼,年龄24～65岁。所有患者于手术前点抗生素眼药水,呋嘛合剂滴鼻液滴鼻,请耳鼻喉科会诊排除鼻中隔偏曲,鼻窦炎,鼻腔息肉。随机分为治疗组(34例,鼻腔泪囊吻合术中应用了透明质酸钠)和对照组(34例,常规鼻腔泪囊吻合术)。分别于手术后1,2,3,7,14d;1,6,12mo观察鼻腔渗血及伤口恢复情况,泪道通畅程度,溢泪情况,对其疗效进行比较,并统计学处理。结果:手术后观察15mo,治疗组34眼,治愈(溢泪、流脓症状消失,冲洗泪道通畅)33眼;好转(症状减轻,冲洗泪道通畅,但仍有溢泪症状)1眼;无效(症状无缓解,冲洗时不通,有溢脓现象)0眼,治愈率97%。对照组34眼,治愈30眼,好转3眼,无效1眼,治愈率88%。结论:透明质酸钠应用于鼻腔泪囊吻合术,可减少手术后渗血,避免吻合口粘连,保持吻合口通畅状况,增加手术的成功率。     

泪道置管联合外路泪囊鼻腔吻合术治疗慢性泪囊炎合并上泪道狭窄

目的:探讨泪道置管联合外路泪囊鼻腔吻合术治疗慢性泪囊炎合并上泪道狭窄的临床疗效。方法:回顾性分析33例33眼慢性泪囊炎合并上泪道狭窄的患者资料,所有患者在进行外路泪囊鼻腔吻合术同时于上泪道留置硅胶泪道引流管,泪管留置时间为6mo。患者于术后1wk;1,3,6,9mo复查,观察术眼泪道通畅、溢泪、溢脓等情况。结果:术后1wk~6mo复查,冲洗泪道通畅率100%,均无溢泪;术后6mo取出泪道置管,取管后3mo复查,32例(97%)冲洗泪道通畅,无溢泪;1例(3%)冲洗阻力大,溢泪症状减轻。2例(6%)泪小点轻度撕裂,无其他并发症。结论:泪道置管联合外路泪囊鼻腔吻合术能够有效治疗慢性泪囊炎合并上泪道狭窄。     

泪囊鼻腔吻合联合泪道内窥镜下泪小管置管治疗泪囊囊肿

目的探讨泪囊鼻腔吻合联合泪道内窥镜下泪小管置管术治疗泪囊囊肿的效果。方法泪囊囊肿16例（16眼）在局麻下行泪囊鼻腔吻合术的同时应用泪道内窥镜系统对泪小管泪总管进行检查,针对阻塞部位进行激光或电钻治疗后,逆行植入环形泪小管内硅胶管。1周拔除引流管,拆除皮肤缝线。3~6个月拔除泪小管内硅胶管。术后随访6个月~2 a,观察术后囊肿治愈率,泪道冲洗通畅情况及泪溢症状是否改善。结果泪囊囊肿全部消失,有效率100%。泪道冲洗通畅14例占87.5%,2例有部分回流占12.5%。以上患者溢泪症状基本消失。结论泪囊鼻腔吻合联合泪道内窥镜下泪小管置管术治疗泪囊囊肿的疗效显著。     

新生儿泪囊炎综合治疗105例分析

一、资料与方法1.共 10 5例 12 6只眼 ;其中单侧 84例 ,双侧 2 1例 ;男 6 8例 78只眼 ,女 37例 48只眼。年龄最大为 3岁 ,最小为 36天。均在出生后数天至 6个月发生。治疗方法为综合阶梯性治疗。即仅有溢泪者 ,先行按摩泪囊治疗 1周 ,无效时予上泪小点封闭加压冲洗泪道。溢泪伴溢脓者 ,行上泪小点封闭加压冲洗泪道 ,5次以上无效者给予泪道探通术 ,泪道探通术无效者建议行手术治疗。2 .方法(1)泪道按摩法 :用拇指沿上泪道按摩泪囊 ,并向鼻腔方向挤压 ,每日进行数次。(2 )上泪小点封闭加压冲洗法 :用 0 .5 %地卡因滴眼 2次后 ,患儿仰卧 ,术者…     

泪囊鼻腔造孔术后远期闭锁与鼻泪管复通现象

目的：报告275例(310只眼)慢性泪囊炎接受鼻内镜下经鼻行泪囊鼻腔造孔术治疗后，9只眼患者自然泪道复通现象。方法：275例(310只眼)慢性泪囊病变患者接受鼻内镜下泪囊鼻腔造孔术，手术在局部或全身麻醉下进行。术后随访包括鼻内镜检查处理、泪道冲洗及鼻腔局部应用糖皮质激素。结果：随访3～60个月，治愈率75．3％，好转率11．7％，总有效率为87．0％，无效为13．0％。275例(310只眼)中，9只眼术后1年泪囊鼻腔造孔瘢痕闭锁，冲洗液自泪囊鼻腔自然开口流出。结论：慢性泪囊炎泪道下端阻塞并非完全不可逆，在手术造孔、建立泪液旁路引流途径之后，原来阻塞的鼻泪管局部粘膜炎症可以缓解。重新发挥泪液排出功能。     

丝裂霉素C在泪道阻塞及慢性泪囊炎治疗中的应用

泪道阻塞和慢性泪囊炎不仅有泪溢、流脓等症状 ,又是球后视神经炎、眶蜂窝组织炎、鼻窦炎等疾病的重要诱因。我院自 1995年 2月至 1998年 7月采用泪道探通联合丝裂霉素Ｃ(ｍｉｔｏｍｙｃｉｎ Ｃ ,ＭＭＣ)冲洗泪道治疗泪道阻塞及慢性泪囊炎患者 5 5例 ( 75只眼 ) ,疗效满意 ,报告如下。1　资料与方法资料 :选择门诊就诊的泪道阻塞及慢性泪囊炎患者 110例14 5只眼 ,用抽签法分为两组 ,Ａ组为 5 5例 75只眼 ,男 2 2例 ,女33例 ,年龄 2 4～ 6 5岁。Ｂ组为 5 5例 70只眼 ,男 2 0例 ,女 35例 ,年龄 2 7～ 5 9岁。所有患者均行泪道造影检查 ,排除泪…     

鼻内镜下经鼻泪囊鼻腔吻合术治疗复发性泪囊炎的临床效果

目的评价鼻内镜下经鼻泪囊鼻腔吻合术治疗复发性泪囊炎的临床效果。方法回顾性病例系列研究。选取徐州医科大学附属徐州市立医院2018年1月至2022年6月住院行鼻内镜下经鼻泪囊鼻腔吻合术治疗的复发性泪囊炎31例(31眼)的临床资料, 其中泪道置管术后管留置复发者9例, 外路泪囊鼻腔吻合术后复发者12例, 鼻内镜下泪囊鼻腔吻合术后复发者10例。术后随访3个月至1年, 分析患者复发原因, 观察吻合口是否开放、泪道冲洗结果及术后症状改善情况。结果泪道置管术后复发者复发原因为泪囊黏膜增生肥厚导致泪囊腔变小, 影响泪液引流;泪囊鼻腔吻合术后复发者复发原因有:骨窗制作不适19例(86.36%)、吻合口与鼻腔粘连者4例(18.18%)、泪囊黏膜误与鼻窦黏膜吻合者1例(4.54%)。31例均行经鼻内镜下泪囊鼻腔吻合术, 29例吻合口开放, 冲洗泪道通畅, 溢泪、溢脓症状消失, 均治愈, 2例有轻微溢泪, 吻合口开放, 泪道冲洗通畅, 溢脓症状消失, 均好转, 治愈率93.55%, 有效率100.00%。结论鼻内镜下泪囊鼻腔吻合术治疗复发性泪囊炎损伤小, 疗效确切, 手术成功率高。     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

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Effects of Adenosine Agonists on Intraocular Pressure and Aqueous Humor Dynamics in Cynomolgus Monkeys

The effects of single or multiple topical doses of the relatively selective A₁adenosine receptor agonists (R)-phenylisopropyladenosine (R-PIA) and N⁶-cyclohexyladenosine (CHA) on intraocular pressure (IOP), aqueous humor flow (AHF) and outflow facility were investigated in ocular normotensive cynomolgus monkeys. IOP and AHF were determined, under ketamine anesthesia, by Goldmann applanation tonometry and fluorophotometry, respectively. Total outflow facility was determined by anterior chamber perfusion under pentobarbital anesthesia. A single unilateral topical application of R-PIA (20–250 μg) or CHA (20–500 μg) produced ocular hypertension (maximum rise=4.9 or 3.5 mmHg) within 30 min, followed by ocular hypotension (maximum fall=2.1 or 3.6 mmHg) from 2–6 hr. The relatively selective adenosine A₂antagonist 3,7-dimethyl-1-propargylxanthine (DMPX, 320 μg) inhibited the early hypertension, without influencing the hypotension. Neither 100 μg R-PIA nor 500 μg CHA clearly altered AHF. Total outflow facility was increased by 71% 3 hr after 100 μg R-PIA. In conclusion, the early ocular hypertension produced by topical adenosine agonists in cynomolgus monkeys is associated with the activation of adenosine A₂receptors, while the subsequent hypotension appears to be mediated by adenosine A₁receptors and results primarily from increased outflow facility.