泪道阻塞部位的分布特点及相关因素的初步研究

目的:研究泪道阻塞性疾病患者中泪道阻塞部位的分布特点,并探讨泪道阻塞发病的相关因素。方法:选取2005-01/2008-03我院眼科门诊就诊患者634例(634眼),取单眼(双眼患者随机选取1眼)作为研究对象,在获得知情同意后进行泪道阻塞性疾病问卷调查、泪道探查冲洗及鼻内窥镜检查,对其中泪道探查冲洗不通畅患者进行泪道造影、泪道CT三维重建等检查,明确诊断以及阻塞部位,对确诊的泪道阻塞患者进行阻塞部位分布特点进行研究,分析其相关因素。结果:泪道阻塞患者共315例,男女之比为1∶2.2,年龄7～83(平均49.5)岁。41～60岁患者所占比例最大,各职业中工人所占比例最大。泪道阻塞各部位所占比例不同,由高到低依次为鼻泪管上段、鼻泪管下段、下泪小管、泪总管、下泪小点、上泪小管、上泪小点阻塞。泪道阻塞的发生受多种因素影响,有眼部炎症、邻近组织疾病、家族泪道病史者泪道阻塞患者的发生率高于无以上因素患者,差异有统计学意义(χ2检验,P<0.05),其中有结膜炎、睑缘炎病史者发生泪道阻塞部位中上下泪小管、上下泪小点所占比例较大,有鼻炎、鼻窦炎病史者发生泪道阻塞部位中鼻泪管上、下段所占比例较大。结论:泪道阻塞各部位所占比例不同。泪道阻塞的发生受多种因素影响,其中有结膜炎、睑缘炎病史者发生泪道阻塞部位中上下泪小管、上下泪小点所占比例较大,有鼻炎、鼻窦炎病史者发生泪道阻塞部位中鼻泪管上、下段所占比例较大。

Primary study on the distribution characters of obstructed portions and risk factors of lacrimal duct obstruction

AIM:To study the distribution characters of lacrimal duct obstructed portions in a hospital-based population and to evaluate the risk factors associated with lacrimal duct obstruction. METHODS: A total of 634 patients (634 eyes) were screened for lacrimal duct obstruction diseases (LDOD) from January 2005 to March 2008. After informed consent was obtained from subjects, a questionnaire was used, when a respondent indicated the presence of symptoms, probing and irrigating lacrimal passage were performed. Subjects whose lacrimal passage were obstructed accepted the relate tests including X-ray dacryocystography with iodine oil and CT scan of lacrimal passage, and nasal endoscope; Then a case-control study was conducted to those subjects who were deemed to be suffering from LDOD and to evaluate the risk factors associated with LDOD. RESULTS: LDOD subjects has a percentage of 49.7(315/634) in the study subjects, it was higher in females than males, the ratio is 2.2∶ 1 , and the occupation group of factory workers is the maximum percentage of 49.5. The following factors were associated with LDOD in case-control study: a history of ocular inflammation (χ2=6.484, P<0.05), a history of nasal diseases (χ2=30.377, P<0.05), and a history of family lacrimal duct diseases (χ2=23.080, P<0.05), its show that a majority of subjects with punctum and canaliculus obstruction has a history of conjunctivitis or blepharitis, and a majority of subjects with nasolacrimal duct obstruction has a history of coryza, sinusitis.CONCLUSION: It has significant diversity in different position of lacrimal passage, including superior punctum, inferior punctum, and superior canaliculus, inferior canaliculus, and common canaliculus, upper and lower portion of nasolacrimal duct. There were many factors such as history of ocular inflammation, diseases of adjacent tissues, and a history of family lacrimal duct diseases may contribute LDOD.