眼科 ›› 2014, Vol. 23 ›› Issue (4): 226-229.doi: 10.13281/j.cnki.issn.1004-4469.2014.04.003

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关于泪液系统的概念及意义

张敬先  邓宏伟   

  1. 518040广东省深圳市,暨南大学附属深圳市眼科医院  深圳市眼科学重点实验室
  • 收稿日期:2014-04-29 出版日期:2014-07-25 发布日期:2014-07-22
  • 通讯作者: 邓宏伟,Email:dhw110@126.com

The concept and meaning of lacrimal system

ZHANG Jing-xian, DENG Hong-wei.   

  1. Shenzhen Eye Hospital, Hospital Affiliated to Jinan University, Shenzhen Key Laboratory of Department of Ophthalmology,  Shenzhen 518040, China 
  • Received:2014-04-29 Online:2014-07-25 Published:2014-07-22
  • Contact: DENG Hong-wei, Email: dhw110@126.com

摘要: 应激性泪液(感情泪、刺激泪)、平常性泪液的来源、机制、功用、排除路径有所差异。基础泪液生成机制一直存在争议,我们提出“周期性瞬目是基础泪液分泌产生的动力源”假说。本文叙述了以周期性瞬目运动启动基础泪液分泌机制,阐述了泪液功能运作包括:睑缘推动两条泪河合二为一再一分为二,周期性地涂布与更新前泪膜;同时瞬目运动周期地挤压和放松挤压泪囊,拉动泪小管壁产生泪泵作用,在前泪膜汽化性排除的同时,驱动泪河有序地移行到泪湖,此为泪道非管性段;泪泵作用令泪点主动吸取泪湖泪液进入管性泪道以排出。在泪囊和泪小管、鼻泪管衔接处以及鼻泪管下口,均有黏膜皱褶样瓣膜,且鼻泪管纤毛定向摆动,使基础泪液移行致鼻泪管下口,泪液再汽化进入呼吸气流,排出或吸入。强调了将泪液、结膜、结膜囊、眼睑和眼睑瞬目运动纳入泪液系统的必要性。文中首次提出“平常性泪液、汽化性泪道、泪道非管性段与管性段以及这两段的衔接点”等新概念。(眼科, 2014, 23: 226-229)

Abstract:  Emotional tears, stimulated tears and basic tears have with their own origin, mechanism, function and excluded paths. We focus on the controversial points in basic tear secretion mechanism, and according to our clinical observation results we put forward the hypothesis that "periodic blink is the power source of secrete basal tear”. We describe in this paper that the periodic blink movement starting basal tear secretion of tear function mechanism and operation. The eyelid movement promotes two tear rivers become one again divides into two, which periodically updates the front tear film, and at the same time blink movement squeezing and relaxing extrusion lacrimal sac, pulling the canalicular wall produces lacrimal pump action. The front tear film is evaporated out and at the same time drives the tear rivers and orderly migrating to the tear lake, which is the lacrimal non-tube section part. Lacrimal pump acts to take tears from the tears lake into the lacrimal duct to exclude. There is mucous membrane between the junction of lacrimal sac, lacrimal canaliculus and nasolacrimal duct. The directional swing of the nasolacrimal duct cilium makes basic tear transitional to the nasolacrimal duct outlet, and tear degasification enters the respiratory airflow, discharge or inhalation. This article explains the necessity of lacrimal system including the conjunctiva, eyelids and conjunctival sac, eyelid blinking. We firstly propose some new concepts, such as the ordinary tear, vaporization of lacrimal duct and lacrimal non-tube section part, tube section part and the connection point of the two section parts. (Ophthalmol CHN, 2014, 23: 226-229)