回顾191例泪腺占位性病变临床分析及术后随访观察

Clinical analysis and follow-up of 191 cases of lacrimal gland occupying lesions

摘要:

目的：探讨191例泪腺占位性病变的临床特点及术后随访情况。

方法：选取2011-01/2015-08我科收治的191例221眼泪腺占位患者，总结其临床特征，并结合病史、影像、病理资料、地域特色进行分析。所有患者行泪腺肿瘤摘除，术后随访1a。

结果：患者191例221眼中，男44例49眼，女147例172眼。炎症性病变171眼，依次是IgG₄硬化性泪腺炎66眼、慢性泪腺炎27眼、泪腺脱垂伴炎性肿大54眼、Grave's病24眼。淋巴组织增生性病变16眼，依次是恶性淋巴瘤6眼、良性淋巴组织增生10眼。上皮性病变34眼，依次是多形性腺瘤26眼、多形性腺癌2眼、腺样囊性癌3眼、腺癌3眼。泪腺占位性病变以IgG₄硬化性泪腺炎、泪腺脱垂伴炎性肿大多见，其中汉族159眼、维族36眼、哈萨克族16眼、蒙古族10眼。手术后主要表现为眼部干涩，哭时无泪，以双侧泪腺摘除者明显，但局部使用人工泪液可以缓解，无严重不良反应。

结论：病史及影像特点对泪腺占位性病变的诊断和鉴别诊断有很大的帮助，新疆地区泪腺占位，以非上皮性病变最为常见，其次是上皮性病变，多发生于汉族、维族患者，而其它民族少有发生，手术后眼部干涩及哭时无泪为主要症状。对病程短且有干眼倾向的患者需延迟摘除。

Abstract:

AIM: To investigate the clinical characteristics and follow-up of 191 patients with lacrimal glandoccupying lesions.

METHODS: We selected 191 patients(221 eyes)with lacrimal gland occupancy from January 2011 to August 2015. All patients underwent lacrimal gland tumor removal and were followed up for 1a.

RESULTS: In the 191 patients(221 eyes), 44 were male(49 eyes)and 147 were female(172 eyes). There were inflammatory lesions in 171 eyes, constituted by IgG₄ sclerosing dacryocystitis 66 eyes, 27 eyes of chronic lacrimal gland, lacrimal gland prolapse with inflammatory enlargement 54 eyes, Grave's disease in 24 eyes; 16 eyes of lymphoid hyperplastic lesions, constituted by malignant lymphoma in 6 eyes, benign lymphoid hyperplasia in 10 eyes; epithelial lesions in 34 eyes, constituted by pleomorphic adenoma in 26 eyes, 2 eyes of pleomorphic adenocarcinoma, adenoid cystic carcinoma in 3 eyes, 3 eyes of adenocarcinoma. Lacrimal glandoccupying lesions with IgG₄ sclerosing dacryocystitis, lacrimal gland prolapse associated with inflammatory enlargement were the most common, of which 159 eyes of Han, Uighur 36 eyes, Kazak 16 eyes, 10 eyes of Mongolian. After surgery, mainly symptoms were dry eye, crying with no tears, with bilateral lacrimal gland removed significantly, but the local use of artificial tears can ease those symptoms with no serious adverse reactions.

CONCLUSION: History and imaging characteristics of lacrimal gland-occupying lesions give a great help to the diagnosis and differential diagnosis. In Xinjiang region, lacrimal gland, with non-epithelial lesions is the most common, followed by epithelial lesions, occurred in the Han, Uighur patients, and rare occurred in other ethnic. Dry eye after surgery and crying with no tears are the main symptoms. Patients with short course of disease and dry eye tend to delay the removal of patients.