泪腺导管囊肿12例临床诊治分析

Clinical diagnosis and treatment of 12 cases of dacryops

目的研究泪腺导管囊肿的临床特点及治疗方法，为临床诊断和治疗提供参考。方法回顾性分析2010年8月至2014年8月在武警总医院与河北省眼科医院手术治疗并病理诊断为泪腺导管囊肿的病例，研究其临床特点、影像表现、治疗方法及预后。结果共12例患者，最小16岁，最大83岁，平均（40．58±6．10）岁。男7例，女5例；右眶3例，左眶8例，双眶1例。病程20d至2年，平均（3．74±1．20）个月。4例次眼红后发现眼部肿物，1例次表现为流泪后肿物增大，1例次为在外院术后复发，9例次（10眶）外眦部皮肤隆起，3例次（3眶）外观正常，8例次眶病变周围均局限性充血，2例次发现泪腺开口内有睫毛。所有患者均行手术治疗，5例次术中囊肿破裂，其中3例次注入医用透明质酸钠凝胶后完整摘除，1例次术中发现囊腔内有睫毛，术后复查均无复发，所有患者手术前后均无眼干表现。结论泪腺导管囊肿为一种少见泪腺疾病，易于诊断，其病因尚待进一步研究，手术切除时容易破裂，完整切除是防止术后复发的关键。

Objective To explore the clinical features and therapeutic methods of dacryops and provide references to clinical diagnosis and treatment. Methods Retrospective analyzed the patients diagnosed as dacryops in the general hospital of armed police force and Hebei eye hospital, the clinical features, imagine manifest, therapeutic methods and prognosis were studied. Results Twelve patients were collected. Ages from 16 years to 83 years （mean 40.58±6.10 years）, 7 cases were male, 5 female. Three cases occurred in the right orbit, 8 in lefts orbit, i in bilateral orbit. The course of disease ranged from 20 days to 2 years （mean 3.74±1.20 months）. Four cases noticed the lesion after conjunctival injection, 1 enlarged after lacrimation, 1 recurrent after surgery in other hospital. Nine cases （10 orbits） appeared bump in lateral canthus, 5 normal. Eight cases appeared hyperemia around the lesion. 2 noticed eyelashes in the dacrimal duct outlet, all patients underwent surgery excision, 5 cases of cyst ruptured during operation, 3 removal the lesion completely after injecting medical sodium hyaluronate gel into the lumen of the cyst. One case noticed an eyelash in lumen. All patients had no recurrence after surgery and no symptom of dry eyes. Conclusions Dacryop is a rare lacrimal gland disease. It＇s easy to diagnose. The pathogenesis is unclear, the cyst apt to rupture during operation. Completely removal the lesion is the key point to avoid recurrence.