曲安奈德局部注射治疗泪腺炎(附10例临床观察)

Local injection of triamcinolone into the lacrimal to treat dacryadenitis

目的探讨长效皮质类固醇激素曲安奈德局部注射治疗泪腺炎的效果。方法自2002年6月-2005年9月对10例不愿或不能接受全身激素治疗的患者采取曲安奈德局部注射的方法进行治疗,10例患者均为单侧泪腺炎。取曲安奈德混悬液20mg(0.5ml)加2%利多卡因0.5ml注射于眶外上缘泪腺组织内,局部加压20分钟,隔周后重复注射至病情稳定或局部肿块消失,最多注射5次。结果10例中5例(其中4例为第一次发病,1例曾有过2次复发)患者注射3-5次后治愈,观察6个月-3年未见复发;3例患者(均有过2次以上复发病史者)注射后好转,其中1例又复发2次在再次注射曲安奈德后病情稳定;2例有过多次复发史且多次不规律用口服激素治疗的患者局部注射5次无效,且因反复发作最后接受手术摘除泪腺。结论曲安奈德局部注射治疗泪腺炎对于不愿接受或全身情况不允许大剂量激素治疗的患者为一可行而有效的方法,尤其对于初次发病的患者效果显著。

Objective To detect the effect that long-effect cortin triamcinolone,（TA） treats the dacryadenitis. Method From June 2002 to Sep. 2005, we treated 10 dacryadenitis with triamcinolone （TA）. All the 10 cases are unilateral dacryadenitis and unable or unwillingly to accept general treating of cortin. 20rag （0.5ml） triamcinolone mixing with 0.5ml lidocain was injected into the tissue of lacrimal which situated at temporal orbit margin.pressed local after injecting. We injected again after 2 weeks of first injection if there is effect. Results 5 cases were cured after 3-5 times of injection, and didn＇t recur after following 6months- 3years; 3 cases were straighten up after injection, but and one of them obtained stable after two times of injection when he recurred; 2 cases invalidated to this injection and finally accepted the operation of exitrpating of lacrimal. Conclusion Injecting triamcinolone into the lacrimal to treat dacryadenitis is an effected method, especially to the patient who is the first time of suffering from dacryadenitis.