泪液分泌与排出动力的临床观察研究
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Clinical study of tear secretion and discharge power
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    摘要:

    目的:通过临床观察,证实“瞬目是基础泪液分泌、前泪膜形成更新与排出泪液共同的动力源”假说。

    方法:临床观察4 216人次。按常规项目检查并进行以下特殊项目的询问与观察:(1)各种泪道阻塞患者60例入睡后溢泪症状。(2)30例觉醒后闭目养神状态下溢泪症状。(3)观察300例新生儿出生后瞬目和溢泪症状。(4)随意观察300人次以上各种瞬目。(5)活体观察360眼泪道逆行置管术后瞬目所产生排出泪液作用。(6)观察暴露性角膜炎者基础泪液分泌。

    结果:(1)各种原因导致的不同类型的所有泪道阻塞患者瞬目停止状态时溢泪症状中止。(2)观察昏迷和醒觉状态下睑裂闭合不全暴露性角膜炎者,并未出现由其他神经反射弧启动的基础泪液分泌。(3)泪道阻塞患者觉醒状态下闭目养神溢泪症状中止者26例,4例明显减轻。(4)观察新生儿:第一声哭啼有泪者接近10%,多数新生儿生后7d(最迟者出生20d)啼哭有泪,出生后都有瞬目动作。(5)活体观察泪道逆行置管术后睁眼状态引流管内水液平面下降; 闭眼状态水液平面上升,幅度约2.0mm左右。(6)随机观察300人次正常人瞬目发生的频率、节律和瞬目中止与自我抑制瞬目持续时间发现下注视最慢,水平注视居中,向上三个注视最快。向下注视眼位抑制瞬目持续时间最长。

    结论:临床观察结果各从不同方面验证“瞬目是基础泪液分泌、前泪膜形成更新与排出泪液共同的动力源”假说。但还需要临床和实验室进一步研究,寻找更直接的验证。

    Abstract:

    AIM: To confirm the hypothesis that "Blink is the power of discharge basal tear secretion, we make many clinical observations.

    METHODS: Clinical observation of 4 216 people of the following items:(1)Epiphora symptoms in the 60 lacrimal duct obstruction patients during sleeping period.(2)26 symptoms of epiphora in the 30 wakefulness closed eyes.(3)300 new birth baby's blink and epiphora.(4)observed more than 300 people's blink.(5)observed in vivo 360 eyes discharged tear effect after the lacrimal retrograde(6)observed the exposure keratitis patients' basal tear secretion.

    RESULTS:(1)All causes of the different types of lacrimal duct obstruction patients stop epiphora symptoms.(2)Patients in coma and with the blepharophimosis dysraphism exposure keratitis, reflex arc did not appear.(3)26 cases with lacrimal duct obstruction meditatively without epiphora symptoms during their eyelid closing and 4 cases significantly reduced.(4)In neonates: the first crying tears was only 10%, most newborns crying tears happened 7 to 20 days after birth, all of the neonates had blink action after birth.(5)Observation in vivo the fluid levels in the lacrimal retrograde catheterization drainage tube, the level was down when eye opened, and the water liquid-level rise when eyes closed, the rate was about 2.0mm.(6)Random observed 300 normal people blink rate, rhythm and blink duration and self-restraint under the gaze of the slowest, the horizontal gaze center, and three upward gazes fastest. Downward gaze eye position to suppress the longest duration of the blink.

    CONCLUSION: The clinical observations confirmed the hypothesis that “Blink is the power of discharge basal tear secretion”. But it needs further clinical and laboratory research to further verification.

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张敬先,邓宏伟,樊宁.泪液分泌与排出动力的临床观察研究.国际眼科杂志, 2013,13(2):405-407.

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  • 收稿日期:2012-08-28
  • 最后修改日期:2013-01-22
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