泪器病与眼表疾病.pptVIP

泪器病 tomy of the lacrimal system Orbital part of the Superior punctum lacrimale uperior la al Interior punctum lacrimale Fig. 3. 1 The lacrimal syste n consists o tear secretion structures and tear drainage 泪液的分泌与排泄: Lacrimal glands 泪腺 canaliculus 泪小管 外眦 球结合膜 泪点 conjunctiva 虚鳍合虞 泪 Nasolacrimal 管d 泪道狭窄或阻塞 [病因」 ①功能性泪溢:无明显泪道阻塞,泪道冲洗通 畅,主要原因是眼轮匝肌松弛,造成眼睑及 泪小点位置异常,泪小点不能接触泪湖,泪 液泵作用减弱或消失,泪液不能进入泪道 ②器质性泪溢:泪小管至鼻泪管的阻塞或狭窄 [临床表现] 主要症状为泪溢 阻塞发生在鼻泪腔末端,并有泪囊炎, 有脓性分泌物返流到结膜囊 [治疗」 确定阻塞部位对治疗方案的选择十分重要。 常用检查方法 ①染料试验(2%荧光素纳溶液)主要用 于儿童。 ②泪道冲洗术 ③泪道探通术 ④X线碘油造影:显示泪囊大小及阻塞 部位 No obstruction Stenosis of the inferior ommon punct Stenosis within the Stenosisof the animal sa inferior canaliculus 常用治疗方法 ①婴儿泪道狭窄或阻塞: 由于鼻泪管下端发育不全,没有完全“管道化” 或留有膜状物阻塞。试用手指有规律的压迫泪囊 区,自下睑眶下线内侧与眼球之间向下压迫,压 迫数次后点抗生素眼水,每日3-4次,坚持数周, 大多数患儿可治愈,若保守治疗无效,半岁以后 可考虑泪道探通术 新生儿泪囊炎 Epiphora and matting Infrequently acute dacryocystitis After application of a topical anesthetic, the probe is arefully introduced into the lower lacrimal system The puncta are dilated and then the valve of Hasner is opened (a and b) In infants six months or older, the procedure is best erformed under short-acting general anesthesia