s conjunctiva puncta canaliculus Sac Nasolacrimal duct 一.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。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 Infrequently acute dacryocystitis Epiphora and matting 新生儿泪囊炎 After application of a topical anesthetic, the probe is carefully 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 performed under short-acting general anesthesia. 泪道探通术
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