摘要
目的通过观察泪小管炎诊治过程中的超声生物显微镜(UBM)影像学特征,探讨其在泪小管炎的诊断及治疗效果评价中的应用价值。方法对8例(8眼)成人泪小管行UBM检查,取泪小管分泌物和结石进行细菌及真菌培养以确诊;应用泪小管探通联合泪小管灌注安尔碘Ⅲ型皮肤黏膜消毒剂治疗,观察治疗过程中泪小管炎的UBM影像学变化特点,对泪小管炎疗效评价提供影像学依据。结果 UBM显示:病变区泪小管管腔明显膨大扩张,部分病变管腔内可见点状中回声。细菌培养3例阳性,其中金黄色葡萄球菌2例,链球菌1例;放线菌培养4例阳性,其中1例同时合并链球菌阳性;真菌培养阳性1例为曲霉菌属;细菌、放线菌及真菌培养均阴性1例。泪小管结石6例,病理检查结果为曲霉菌1例,放线菌5例。药物灌洗疗程9～27 d,第3—5天炎症反应开始明显减轻,泪小管分泌物减少,红肿症状减轻。7例患者经治疗后患眼无溢泪,泪小管病变区无红肿,泪道冲洗通畅,无分泌物溢出,UBM显示泪小管管腔通畅。随访6个月以上无复发。1例患者经治疗后患眼无溢泪,泪小管病变区无红肿,无分泌物溢出,泪道冲洗通而不畅,UBM显示泪小管管腔狭窄。结论 UBM检查,泪小管分泌物细菌、真菌培养联合泪小管结石病理检查是诊断泪小管炎的可靠方法。应用泪小管探通联合泪小管灌注安尔碘Ⅲ型皮肤黏膜消毒剂治疗泪小管炎效果明显。治疗过程中UBM图像的变化特点可对疗效提供确切影像学依据。
Objective It is to observe the imaging characteristics of ultrasound biomicroscope （UBM） of canaliculitis and approach the available value in the diagnosis and treatment process of canaliculitis. Methods Eight out-patient cases （8 eyes） with adult canalicular inflammation were chosen to diagnose by UBM examination, the lacrimal canaliculus secretions and con cretions were diagnosed definitely through bacterial and fungal culture or strain identification. Cooperation treatment of probed canalicular and injected Anerdian of the skin and mucous type into canalicular was executed, and then the Changes in imaging characteristics of UBM in the treatment process were observed to provide the imaging basis in curative effect evaluation of canaliculitis. Results UBM imaging of canaliculitis showed obvious ectasia of the canaliculus and medium point-like echo could be seen in some lesions of canalicular. Positive result was found in 3 cases by bacterial culture, included 2 cases with Staphylococcus and 1 patient with Streptococcus ; in 4 cases by actinomycetes culture, included I cases combined with positive Streptococcus ; in 1 case by fungal culture as genus Aspergillus; negative result was found in 1 case by bacteria, actinomycetes and fungal cultures. Lacrimal canaliculus concretion were found in 6 cases, pathological examination found that 1 case was As- pergillus, 5 cases were actinomycetes. The Anerdian of the skin and mucous type course of injection 9--27d, and showed effect from the first 3--5 day, the lacrimal canaliculus secretion was decrease, dacryon red and swollen was ease off. 7 cases were not epiphora by treatment, dacryon red and swollen was fully recovered. They were patency of rinsing lacrimal. The lacri mal canaliculus secretions were cured. UBM showed they were unobstructed in lesions of canalicular, and were followed up for more than six months without recurrence of the performance. 1 case was not epiphora by treatment, the lacrimal canaliculus se cretion was cured, dacryon red and swollen was
出处
《现代中西医结合杂志》
CAS
2013年第30期3313-3316,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
河北省卫生厅科研基金项目(20110212)
关键词
UBM
泪小管
泪小管炎
泪小管结石
泪小管探通
UBM
lacrimal canaliculus
canaliculitis
lacrimal canlaliculus concretion
probe canalicular
