泪道内窥镜在观察患者泪道黏膜及阻塞部位中的应用

目的：：通过泪道内窥镜了解泪道阻塞性疾病( lacrimal duct obstruction diseases,LDOD)患者泪道黏膜状态及阻塞的部位。方法：回顾性分析2010-06-01/2012-06-01在华中科技大学同济医学院附属同济医院眼科门诊就诊的244例275眼泪道阻塞患者,患者均在局部麻醉下泪道内窥镜直视下观察泪道阻塞部位及泪道黏膜情况。结果：患者年龄9~82(平均41.3)岁；女210例230眼(83.6％),男34例45眼(16.4％)；左眼102例(41.8％),右眼111例(45.5％),双眼31例(12.7％),双眼患者选取溢泪或溢脓症状严重眼行泪道内窥镜的检查。以上244例275眼患者中,上泪小管阻塞2例2眼(0.7％),下泪小管阻塞13例13眼(4.7％),泪总管阻塞19例22眼(8％),鼻泪管阻塞164例186眼(67.6％),多部位阻塞46例52眼(18.9％)。各段泪道黏膜有黏膜充血、出血、纤维膜形成、瘢痕形成等多种表现,泪小管和泪囊以黏膜充血最常见,鼻泪管以纤维膜形成最常见。结论：泪道内窥镜能在直视下观察泪道阻塞部位以及泪道黏膜的情况,对泪道疾病的诊断和制定下一步治疗方案有重要意义。

Application of lacrimal endoscopy on observing lacrimal passage mucosa condition and obstructive location

AIM:To observe the Iocation of the obstruction and the condition of mucosa in the patients who suffered from the IacrimaI duct obstruction diseases ( LDOD ) through IacrimaI endoscopy. METHODS: Retrospective anaIysis of 244 patients ( 275 eyes ) from Department of OphthaImoIogy in Tongji HospitaI AffiIiated to Tongji MedicaI CoIIege, Huazhong University of Science and TechnoIogy from June 1 st 2010 to June 1st 2012 were taken. AII the patients were examined by IacrimaI endoscopy and the resuIts we observed were anaIyzed. RESULTS:The age of the patients was 9 ~82 ( average 41. 3 ) year oId. There were 210 femaIes with 230 eyes (83. 6%) and 34 maIes with 45 eyes (16. 4%); gender of eyes: 102 cases ( 41. 8%) were Ieft eyes, 111 cases (45. 5%) were right eyes and 31 cases ( 12. 7%) were binocuIar ( in the 31 cases, the eye with more severe epiphora and pyorrhea was examined ) . In aII the 244 patients with 275 eyes, there were 2 eyes in 2 cases (0. 7%) with the upper canaIicuIus obstructions, 13 eyes in 13 cases (4. 7%) the Iower canaIicuIus obstructions, 22 eyes in 19 cases (8%) with the generaI IacrimaI passage obstructions, 186 eyes in 164 cases ( 67. 6%) with the nasoIacrimaI duct obstructions, 52 eyes in 46 cases ( 18. 9%) with combined parts obstructions . The mucosa conditions of each IacrimaI passage were different, for exampIe, hyperemia, hemorrhage, fibrous membranes, and cicatrisation and so on. But hyperemia was the most common at ones IacrimaI canaIicuIus and IacrimaI sac, and fibrous membrane was the most common one at nasoIacrimaI duct. . CONCLUSION: We can observe the obstructive Iocations and mucosa condition of the IacrimaI passage through IacrimaI endoscopy, and it pIays an important roIe in the examination and further treatment of the LDOD.