189例主诉流泪患者的病因分析  

Clinical etiology analysis of 189 patients with epiphora complaint

作　　者：胥利平[1] 周明[1] 刘豪杰[1] 沈健[1] XU Li-ping ZHOU Ming LIU Hao-jie SHEN Jian(Department of Ophthalmology, the Affiliated Zhongshan Hospital, Dalian University, Dalian 116001, China)

机构地区：[1]大连大学附属中山医院眼科,辽宁省大连市116001

出　　处：《眼科》2016年第5期343-346,共4页Ophthalmology in China

摘　　要：目的 分析以流泪为主诉患者的病因。设计 回顾性病例系列。研究对象 2013年1月-2014年12月以流泪为主诉就诊于大连大学附属中山医院的成年患者189例（321眼）。方法 所有患者完成问卷调查，外眼、裂隙灯显微镜、鼻腔检查及泪道冲洗。有眼干涩或异物感等症状或泪河高度偏低者行泪液分泌试验及泪膜破裂时间（BUT）检查。主要指标 病因构成比。结果 321眼中各种原因泪道狭窄或阻塞174眼（54.21%），干眼症27眼（8.41%），结膜松弛8眼（2.49%），泪阜肥大2眼（0.62%），眼睑松弛2眼（0.62%），鼻腔疾病2眼（0.62%），结膜炎8眼（2.49%），鳄鱼泪2眼（0.62%），视疲劳20眼（6.23%）。2种以上原因76眼（23.68%），其中泪道狭窄或阻塞合并干眼症43眼（13.40%），泪道狭窄或阻塞并干眼症与结膜松弛6眼（1.87%），泪道狭窄并干眼症与结膜炎2眼（0.62%），干眼症及结膜松弛6眼（1.87%），泪道狭窄或阻塞合并结膜松弛9眼（2.80%），结膜松弛及泪阜肥大5眼（1.56%），泪道狭窄或阻塞合并结膜松弛及眼睑松弛3眼（0.94%），泪道阻塞合并泪阜肥大1眼（0.31%），泪道阻塞合并倒睫1眼（0.31%）。结论 泪道狭窄或阻塞是主诉流泪者的主要原因，多因素原因中干眼症合并泪道狭窄或阻塞比例较大。（眼科，2016, 25：343-346）Objective To investigate the clinical etiology of epiphora complaint. Design Retrospective case series. Participants 189 adults （321 eyes） who complained of epiphora as the main symptoms were included from January 2013 to December 2014 in the Affiliated Zhongshan Hospital of Dalian University. Methods All the patients underwent questionnaire, extraocular examination, slit lamp microscope examination, nasal cavity examination and lavage of lacrimal passages. Those who had simultaneous dry eye symptoms or foreign body sensation and those whose tear river height was abnormally low under slit lamp examination underwent examinations of Schirmer I test （Sit） and tear break-up time （BUT）. Main Outcome Measures Constituent ratio of etiology. Results The causes for epiphora were lacrimal duct stenosis or occlusion in 174 eyes（54.21%）, dry eye syndrome for 27 eyes （8.41%）, conjunctivochalasis in 8 eyes （2.49%）, lacrimal caruncle hypertrophyin were conjunctivitism in 2 eyes （0.62%） , eyelid relaxation in 2 eyes （0.62%）, of unilateral nasal diseases in 2 eyes （0.62%）, conjunctivitis in 8 eyes （2.49%） , crocodile tears in 2 eyes （0.62%）, visual fatigue in 20 eyes （6.23%）. 76 eyes （23.68%） teared because of 2 kinds or more reasons： of which the lacrimal duct stenosis or obstruction with dry eye syndrome in 43 eyes （13.40%）, lacrimal duct stenosis or obstruction and dry eye and conjunctivochalasis in 6 eyes （1.87%）, lacrimal duct stenosis and dry eye and conjunctivitis in 2 eyes （0.62%）, dry eye and conjunctivochalasis in 6 eyes （1.87%）. Lacrimal duct stenosis or occlusion with conjunctivochalasis in 9 eyes （2.80%）, conjunctivochalasis and lacrimal caruncle hypertrophy in 5 eyes （1.56%）, lacrimal duct stenosis or occlusion with conjunctivochalasis and eyelid relaxation in 3 eyes （0.94%）, lacrimal duct obstruction combined with lacrimal caruncle hypertrophy in 1 eye （0.31%）, lacrimal duct obstruction with trichiasis in 1 eye （0.31%）. Conclu

关 键 词：流泪/病因学 泪道狭窄 泪道阻塞 干眼症 

分 类 号：R77[医药卫生—眼科]