泪小管超声活体显微镜测量

摘要

目的 探讨运用超声活体显微镜(UBM)测量人泪小管各段管内径的可行性.方法 横断面研究.选取2008年1月至2009年3月武警总医院眼科泪道正常的志愿者80名(80只眼).其中男性40名(40只跟),女性40名(40只限),年龄18 ～82岁,平均41岁.按年龄分为3组:18～40岁,41～60岁,61岁以上.对入选眼行UBM检查,观察活体正常泪小管在UBM图像中的成像特点；测量睁眼状态下上、下泪小管垂直部长度、垂直部近心段、中段、远心段管腔的前后径；测量睁眼状态下上、下泪小管水平部远心段、中段、近心段管腔的前后径和垂直径,根据椭圆面积公式S=πab(a,b分别为1/2前后径和1/2垂直径)计算泪小管水平部各段横截面积.各年龄段间泪小管测量值的比较、泪小管垂直部各段前后径间的比较以及水平部各段横截面积间的比较均采用单因素方差分析；男女间泪小管测量值的比较采用t检验.结果 80只眼中,6只眼泪小管未能清晰成像,成像率92.5％ (74/80).上、下泪小管垂直部长度分别为(2.10±0.12)mm、(2.08±0.10)mm.上泪小管垂直部远心段、中段、近心段管腔前后径值分别为(0.24±0.05) mm、(0.28±0.05) mm、(0.33±0.04) mm(F=16.315,P=0.000),下泪小管垂直部远心段、中段、近心段管腔前后径值分别为(0.23±0.04)mm、(0.28±0.06)mm、(0.32±:0.05) mm( F=17.570,P=0.000).上泪小管水平部远心段、中段、近心段管腔横截面积分别为(0.77±0.13)mm2、(0.62±0.13)mm2、(0.48±0.11 )mm2(F=22.970,P=0.000),下泪小管水平部远心段、中段、近心段管腔横截面积分别为(0.79±0.11 )mm2、(0.63±0.08)mm2、(0.48±0.09) mm2(F=21.45,P=0.000).各年龄段间、男女间泪小管测量值差异无统计学意义(F=0.142～3.954,t=0.105～0.487；P＞0.05).结论 UBM检查活体泪小管具有无创伤性,其测量活体泪小管管内径可行性好.%Objective To study biometric measurements of normal canaliculus in vivo with ultrasound biomicroscope.Methods Cross-sectional study.Eighty volunteers of normal lacrimal duct (80 eyes),including 40 men (40 eyes),40 women (40 eyes),aged from 18 to 82 years old (average 41 years old).Eighty volunteers were divided into three stages,one eye of each volunteer was detected and measured with ultrasound biomicroscope in the goggle state and the imaging characteristics of caanlicular ultrasound biomicroscopy were obtained.The length of the vertical canaliculus,the distal,middle,proximal anteroposterior diameter of the vertical canaliculus,the distal,middle,proximal anteroposterior diameter and vertical diameter of the horizontal canaliculus were measured.According to elliptical area formula S =πab (a =1/2 anteroposterior diameter,b =1/2 vertical diameter)the distal,middle,proximal transverse erea of the horizontal canaliculus were caculated.The differences among age groups and those among distal,middle,proximal measurements were compared by One-way ANOVA analysis.The measurements of canaliculus between male and female were analyzed using t test.Results Eighty volunteers (80 eyes) participated in the study,6 eyes were failed to be imaged,the success rate was 92.5％ (74/80).The length of vertical canaliculus of superior canaliculus were (2.10 ±0.12)mm,of inferior canaliculus were (2.08 ±0.10)mm.The proximal,middle,distal anteroposterior diameter of the vertical part of superior canaliculus respectively were (0.24±0.05) nun,(0.28 ± 0.05) mm,(0.33 ± 0.04) mm(F =16.315,P =0.000),of inferior analiculus were (0.23 + 0.04 ) mm,( 0.28 ± 0.06 ) mm,( 0.32± 0.05 ) mm ( F=17.570,P =0.000 ).The proximal,middle,distal transverse erea of the horizontal part of superior canaliculus respectly were ( 0.77 +0.13) mm2,(0.62 ±0.13) mm2,(0.48 ±0.11 )mm2(F=22.970,P=0.000),of inferior canaliculus were (0.79 ± 0.11 ) mm2,( 0.63 ± 0.08 ) mm2,( 0.48 ± 0.09 ) hm-2 ( F =21.45,P =0.000) ).There was no significant difference of the canaliculus measurements between male and female(t =0.105-0.487,P ＞0.05 ).No significant differences were found among age groups (F=0.142-3.954,P ＞ 0.05 ).Conclusion It is practicable to measure the normal canaliculus in vivo with UBM.