收稿日期: 2023-08-10
网络出版日期: 2023-12-11
基金资助
广东省农村科技特派员项目(KTPYJ2021021)
Clinical application value of DR⁃dacryocystography in lacrimal duct obstructive diseases
Received date: 2023-08-10
Online published: 2023-12-11
目的 探讨数字X射线摄影?泪道造影术（digital radiography?dacryocystography， DR?DCG）在泪道阻塞性疾病中的临床运用价值，进一步探究DR?DCG对术前评估的指导意义。 方法 收集2019年1?12月因泪道阻塞性疾病在中山大学中山眼科中心就诊的913例患者（1 129眼）的DR?DCG影像资料，进行回顾性分析。 结果 （1）本组 913例（1 129眼）泪道造影中，971眼显影清晰，占86.0%；（2）泪囊显影情况：泪囊增大55眼，正常438眼，缩小478眼；（3）泪道阻塞部位：泪囊前阻塞80眼，高位鼻泪管阻塞874眼，低位鼻泪管阻塞97眼；（4）泪道引流系统阻塞826例，占90.5%，泪道狭窄61例，占6.7%；（5）选择泪囊鼻腔吻合术治疗的患者占62.3%，治愈902例，占98.9%。 结论 DR?DCG可以明确泪囊大小、泪道阻塞具体部位及其扩张程度，具有简便、直观的优点，对泪道阻塞性疾病的诊断及治疗有临床指导价值。
聂时淮 , 郭丽旭 , 刘咏 , 陈荣新 . DR⁃泪道造影术在泪道阻塞性疾病中的临床运用价值[J]. 实用医学杂志, 2023 , 39(22) : 2969 -2973 . DOI: 10.3969/j.issn.1006-5725.2023.22.019
Objective This study aimed to explore the clinical value of DR?dacryocystography （DR?DCG） in lacrimal duct obstructive disease， and to further explore the guiding significance of DR?DCG in preoperative evaluation. Methods The DR?DCG of 913 patients （1129 eyes） who came to Zhongshan Ophthalmic Center from January 2019 to December 2019 were collected and analyzed retrospectively. Results （1）Among the 913 cases （1129 eyes） with dacryocystography， a total of 971 eyes were clearly visualized， accounting for 86%； （2） Situation of lacrimal sac visualization： enlarged lacrimal sac in 55 eyes， normal in 438 eyes， and shrink in 478 eyes； （3） The classification of lacrimal obstruction： anterior lacrimal sac obstruction in 80 eyes， high nasolacrimal duct obstruction in 874 eyes， and low nasolacrimal duct obstruction in 97 eyes； （4） Patients with lacrimal drainage system obstruction are 826 patients， accounting for 90.5%， and there were 61 patients with lacrimal duct stenosis， accounting for 6.7%； （5）Patients who chose dacryocystorhinostomy to treat accounted for 62.3%. 902 patients were cured， accounting for 98.9%. Conclusion DR?DCG can clarify the size of the lacrimal sac， the specific site of lacrimal obstruction and its degree of dilatation， with the advantages of simplicity and intuition， and has clinical guidance value for the diagnosis and treatment of lacrimal obstructive diseases.
| 1 | 于欣悦，陈荣新，梁轩伟. 原发性获得性鼻泪管阻塞发病机制的研究进展［J］. 眼科学报，2021，36（11）：921?927. |
| 2 | GUL A， ASLAN K， KARLI R， et al. A possible cause of nasolacrimal duct obstruction： narrow angle between inferior turbinate and upper part of the medial wall of the maxillary sinus［J］. Curr Eye Res， 2016， 41（6）：729?733. |
| 3 | WANG W， GONG L， WANG Y. Anatomic characteristics of primary acquired nasolacrimal duct obstruction： a comparative computed tomography study［J］. Quant Imaging Med Surg， 2022， 12（11）：5068?5079. |
| 4 | KANG T S， CHO J， KIM J， et al. Modified ocular surface disease index as a screening criteria for dry eye syndrome presenting after successful dacryocystorhinostomy［J］. PLoS One， 2021， 16（2）：e0247168. |
| 5 | MEHTA S， YING G S， HUSSAIN A， et al. Is gastroesophageal reflux disease associated with primary acquired nasolacrimal duct obstruction？［J］. Orbit， 2018， 37（2）：135?139. |
| 6 | BULBUL E， YAZICI A， YANIK B， et al. Morphometric evaluation of bony nasolacrimal canal in a Caucasian population with primary acquired nasolacrimal duct obstruction： a multidetector computed tomography study［J］. Korean J Radiol， 2016， 17（2）： 271. |
| 7 | SAMAREI R， SAMAREI V， AIDENLOO N S， et al. Sinonasal Anatomical Variations and Primary Acquired Nasolacrimal Duct Obstruction： A Single Centre， Case?Control Investigation［J］. Eurasian J Med， 2020， 52（1）：21?24. |
| 8 | ALI M J， PAULSEN F. Prolactin and Prolactin?inducible protein （PIP） in the pathogenesis of primary acquired nasolacrimal duct obstruction （PANDO）［J］. Med Hypotheses， 2019， 125： 137?138. |
| 9 | ALI M J， SCHICHT M， PAULSEN F. Qualitative hormonal profiling of the lacrimal drainage system： potential insights into the etiopathogenesis of primary acquired nasolacrimal duct obstruction［J］. Ophthalmic Plast Reconstr Surg， 2017， 33（5）： 381?388. |
| 10 | DIKICI O， ULUTA? H G. Relationship between primary acquired nasolacrimal duct obstruction， paranasal abnormalities and nasal septal deviation［J］. J Craniofacial Surg， 2020， 31（3）： 782?786. |
| 11 | SAMAREI R， SAMAREI V， AIDENLOO N S， et al. Sinonasal anatomical variations and primary acquired nasolacrimal duct obstruction： a single centre， case?control investigation［J］. Eurasian J Med， 2020， 52（1）： 21?24. |
| 12 | ZHOU X， ZHANG X， ZHOU D， et al. A Narrative Review of Ocular Surface Disease Related to Anti?Glaucomatous Medications［J］. Ophthalmol Ther， 2022， 11（5）：1681?1704. |
| 13 | 薛利利，张苗，张琳. 先天性鼻泪管阻塞的临床治疗［J］. 眼科学报， 2022， 37（10）：795?798. |
| 14 | 黄伟锋，陈荣新，赵静，等. 黏膜瓣泪小点成形术治疗慢性泪小管炎的疗效［J］. 眼科学报，2021，36（11）：881?887. |
| 15 | KAMAO T， ZHENG X， SHIRAISHI A. Outcomes of bicanalicular nasal stent inserted by sheath?guided dacryoendoscope in patients with lacrimal passage obstruction： a retrospective observational study［J］. BMC Ophthalmol， 2021， 21（1）：103. |
| 16 | 谭思敏， 梁德茂. Nd： YAG激光泪道成形术联合泪道支架置入治疗泪道阻塞的疗效及影响因素［J］. 国际眼科杂志， 2020， 20（11）： 1979?1982. |
| 17 | GOEL R， GOLHAIT P， KHANAM S， et al. Comparative evaluation of dacryocystorhinostomy with retrograde intubation and conjunctivo?dacryocystorhinostomy［J］. Can J Ophthalmol， 2023， 58（1）： 39?46. |
| 18 | 张福宏，卢蓉，史剑波. 内镜鼻眼相关外科现状与展望［J］. 眼科学报，2022，37（11）：835?842，909. |
| 19 | ALAM M S， KUNDU D. Is dacryocystectomy effective in reducing epiphora？［J］. Indian J Ophthalmol， 2022， 70（12）：4416?4418. |
| 20 | 汤喜成， 魏厚仁. 超声诊断在泪道疾病中的应用［J］. 实用眼科杂志， 1986，4（7）： 419?421. |
| 21 | ALI M J， SINGH S， NAIK M N， et al. Interactive navigation?guided ophthalmic plastic surgery： the utility of 3D CT?DCG?guided dacryolocalization in secondary acquired lacrimal duct obstructions［J］. Clin Ophthalmol， 2016， 11： 127?133. |
| 22 | HIGASHI H， TAMADA T， MIZUKAWA K， et al. MR dacryocystography： comparison with dacryoendoscopy in positional diagnosis of nasolacrimal duct obstruction［J］. Radiol med， 2016， 121（7）： 580?587. |
| 23 | SINGH S， ALI M J， PAULSEN F. Dacryocystography： from theory to current practice［J］. Ann Anat， 2019， 224： 33?40. |
| 24 | 武俊男，孙悦奇，王康华，等. 经鼻内镜鼻泪管?泪囊切除术的应用解剖［J］. 眼科学报，2022，37（11）：856?863. |
| 25 | BAE S H， PARK J， LEE J K. Comparison of digital subtraction dacryocystography and dacryoendoscopy in patients with Epiphora［J］. Eye， 2021， 35（3）： 877?882. |
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