鼻泪管阻塞性疾病患者鼻泪管管径的研究

摘要

AIM:To measure the transverse diameter of nasolacrimal duct in patients with nasolacrimal duct obstruction,and to analyze the difference of the transverse diameter of the upper,middle and lower nasal nasolacrimal ducts between the diseased eyes and the normal eyes,between the male and the female eyes,and of different ages and sexes and then explore the correlation between the diameter of nasolacrimal duct and nasolacrimal duct obstruction based on computed tomography (CT) dacryocystography.METHODS:From April 2014 to January 2017 in Chengdu University of Traditional Chinese Medicine Affiliated Hospital of ophthalmology in tears or pus for complaints,diagnosis of nasolacrimal duct obstruction in 152 patients (179 sick eyes,125 normal eyes).Among them 25 cases were male (sick eyes 28 eyes,normal eye 22 eyes),127 cases were female (sick eves 151 eyes,normal eyes 103 eyes),age from 4 to 87 years old,mean age 53.44±16.06 years old.All patients with perfusion of 30％ iohexol injection in lacrimal passages,and immediately examined with CT scan,upload CT images on PACS workstation for 3D reconstruction of nasolacrimal duct,oblique coronal of nasolacrimal duct and its adjacent structure were observed.We measured and analyzed the transverse diameters of the upper,middle and lower nasal nasolacrimal ducts between men and women,diseased eyes and non diseased eyes,and between the diseased eyes of different age groups.RESULTS:The transverse diameter of the upper,middle and lower nasal nasolacrimal duct was no significant difference between the diseased eye and the normal eye,between the male and female diseased eyes,and between the diseased eyes of different age groups (P＞0.05).The transverse diameters of the upper,middle and lower nasolacrimal ducts were significantly different between the diseased eyes and the normal eyes (P＜0.001),and the transverse diameter of the middle mouth was the smallest.CONCLUSION:Transverse diameter of bony nasolacrimal duct is not a risk factor for nasolacrimal duct obstruction.%目的:测量鼻泪管阻塞性疾病患者鼻泪管管径,分析患眼与正常眼之间、不同性别患眼之间、不同年龄段患眼骨性鼻泪管上、中、下口横向直径的差异,探讨鼻泪管横向直径与鼻泪管阻塞疾病的关系.方法:收集2014-04/2017-01于成都中医药大学附属医院眼科就诊的鼻泪管阻塞性疾病患者152例(患眼179眼,正常眼125眼),其中男25例(患眼28眼,正常眼22眼),女127例(患眼151眼,正常眼103眼),年龄4～87(平均53.44±16.06)岁.所有患者泪道冲洗后灌注30％碘海醇注射液,并立即行泪道计算机断层扫描(computed tomography,CT)检查,三维重建鼻泪管结构图,于斜冠状位上对鼻泪管及其临近组织结构进行观察,测量并分析患眼与正常眼之间、不同性别患眼之间、不同年龄段患眼之间骨性鼻泪管上、中、下口横向直径的差异.结果:患眼与正常眼之间、不同性别患眼之间、不同年龄段患眼之间骨性鼻泪管上、中、下口横向直径值差异均无统计学意义(P＞0.05).患眼和正常眼的鼻泪管上、中、下口横向直径之间比较,差异均有统计学意义(P＜0.001),其中中口横向直径最小.结论:骨性鼻泪管横向管径不是形成鼻泪管阻塞的主要原因.