泪腺神经痛的诊断与治疗

目的探讨泪腺神经痛的诊断与治疗方法。方法收集我院门诊软组织病痛患者中确诊为泪腺神经痛者16例，进行回顾性分析。分析病因，最大可能为泪腺神经在出眼眶时穿过眶隔处受到卡压所致。治疗方法采用强的松龙混悬液0．6mL（15mg）加2％利多卡因2mL，注射至眼眶外上角骨缘的紧下内方，深及皮下与眶隔处，1周后如仍不愈，再行第2次注射。2周后部分患者再进行第3次注射。结果所有病例皆在注射后10min内止痛，检查神经分布区痛觉消失，数小时后多数病例再现轻度疼痛。1周后11例痊愈。3例经第2次注射痊愈。2例经3次注射后痊愈。注射问隔l周。结论对于疑为泪腺神经痛的病例，查体证实，在排除眼眶内其他病变后，可试行局部注射强的松龙至神经通过眶隔处，方法易行，疗效可靠，不失为首选的治疗方法。

Diagnosis and treatment of lacrimal nerve neuralgia

Objective To discuss the diagnosis and treatment methods for neuralgia of the lacrimal nerve. Methods Totally 16 cases of diagnosed neuralgia of the lacrimal nerve in outpatient department of our hospital were collected and analyzed retrospectively. The etiology of the neuralgia suspected that was due to the entrapment of the nerve when it was passing through the orbital septum. 15 mg prednisolone suspension plus 2 mL lidocaine（2% ） were injected subcutaneously to the medial and inferior part of the outer superior angle of the orbital margin and deep to the orbital septum. The second injection was given if the first one did not work within one week. The third injection was given to some patients two weeks later. Results The pain in all cases was stopped within 10 minutes after the injection. The skin pain sen- sation was lost in the area of the nerve distribution. The pain was reappeared in most cases a few hours later but in mild degree. There were 11 cases recovered one week later,3 cases recovered after the second injection and 2 cases recovered after the third injection. Conclusion Local injection of prednisolone can be regarded as the best treatment for the suspected cases of lacrimal nerve neuralgia after ruling out other intraorbital lesions