单纯疱疹性角膜炎—葡萄膜炎继发青光眼1例误诊分析

1病历摘要患者男,47岁,半月前因感冒后出现左眼羞明、流泪、视物模糊。在当地医院诊断为“角膜炎,”给予全身及局部抗菌药物治疗后,病情加重,来我院就诊。门诊以“单纯疱疹性角膜炎—葡萄膜炎继发青光眼”收入院治疗。入院查:视力:右:1.2,左:0.04,眼压:右14mmHg,左28mmHg。左眼球结膜混合充血,角膜上皮荧光素染色点状着色,角膜知觉减退,角膜中央基质层可见约5×5mm大小的灰白色混浊区,边界不清,角膜后沉着物(Keraticprecipi tates,KP)阳性,前房Tyndall氏征(前房闪辉试验)阳性,瞳孔双侧等大,约4mm×4mm,左眼瞳孔对光反射弱,眼底视不清。入…     

静脉用药后单眼内源性眼内炎2例

例1,女,38岁,入院前4 d因"感冒"发烧,于当地诊所输液治疗,具体用药不详.次日感左眼胀痛,视物不见,当地医院诊为"左眼葡萄膜炎",给予"强的松"口服2 d后转我院.入院查体:视力左眼眼前手动,光定位准,双眼压16 mmHg.右眼未见异常.左眼结膜轻微充血,角膜KP( ),房水Tyndall( ),玻璃体白色混浊( ),眼底看不清.全身各项辅助检查基本正常.入院诊断考虑:左眼全葡萄膜炎,左眼眼内炎?静脉给予大剂量地塞米松抗炎治疗,病情反复.     

前葡萄膜炎误诊12例分析

前葡萄膜炎是一种眼科常见病,若早期即明确诊断,大部分前葡萄膜炎经治疗后,可取得较好的疗效;若早期未能确诊且未及时治疗后可发生严重并发症,使临床诊断更为困难,易导致误诊.宁夏医科大学附属医院眼科自1990-2008年收治了12例因前葡萄膜炎延误治疗而继发青光眼导致角膜重度混浊被误诊为角膜炎的病例,现分析如下.     

中西医结合治疗强直性脊柱炎合并葡萄膜炎2例

强直性脊柱炎 (ａｎｋｙｌｏｓｉｎｇｓｐｏｎｄｙｌｉｔｉｓ ,ＡＳ)是一种病因尚不完全清楚的主要累及轴骨骼的特发性慢性炎症性疾病。约 2 5%患者发生葡萄膜炎 ,且多为急性前葡萄膜炎 (ＡＡＵ) ,有 96 %患者ＨＬＡ Ｂ2 7抗原阳性。近 2年在我科临床收治的急性葡萄膜炎患者中 ,有 2例患者为强直性脊柱炎合并葡萄膜炎 ,且ＨＬＡ Ｂ2 7抗原阳性 ,报告如下。案例 1.患者 ,男 ,4 6岁 ,于 1997年 3月 2 8日以“左眼急性葡萄膜炎”入院。眼科检查 :视力 :右1 5,左 0 0 8。左眼 :睫状充血 ( ) ,角膜 (- ) ,Ｋｐ( ) ,内皮水肿 ,后弹力层皱褶 ( …     

单纯疱疹性角膜-葡萄膜炎引起继发性青光眼

<正> 单纯疱疹性角膜-葡萄膜炎是单疱病毒性角膜炎(HSK)中的一种类型,也是一种常见的致盲的传染性眼病,引起青光眼笔者曾报告2例,国内尚未见报道。现将我们所见23例23只眼,总结如下。临床资料一、一般资料本组为1990年8月～1991年10月门诊观察治疗的病人。男18人,女5人,右眼9例,左眼14例;年龄22～71岁,其中41岁以下的青壮年占92%。二、临床表现与眼部特征 1.病例分型:根据病变深浅程度分为两     

急性特发性重症前葡萄膜炎的门诊治疗观察

急性前葡萄膜炎是眼科门诊常见病,病因不明的特发性病例占一半左右。少数急性特发性重症前葡萄膜炎患者炎症严重,角膜内弹力层皱褶明显,对视力影响大。根据葡萄膜炎激素用药原则,作者对急性特发性重症前葡萄膜炎患者采取门诊治疗方案,现报告如下。     

眼葡萄膜炎相关皮片水肿和LASIK术后角膜瓣接触面的液体积聚

目的:报道两例在准分子激光原位角膜磨镶术(LASIK)后发生角膜病变并伴随前葡萄膜炎的病例。设计:观察性病例报道。方法:1例47岁男性和1例50岁女性患者在LASIK术后发生失明和角膜病变并伴随急性前葡萄膜炎。结果:47岁男性患者,因低度近视行LA SIK手术后在角膜瓣接触面形成瓣间液体囊袋,而50岁女性患者,由于远视行LA SIK手术后,在角膜瓣接触面无液体积聚,但发生明显的皮片水肿。结论:两病例说明在LA SIK术后,发生急性角膜液体积聚合并急性前葡萄膜炎。葡萄膜炎是LASIK术后角膜并发症中威胁视力的一个危险因素。眼葡萄膜炎相关皮片…     

二极管激光经巩膜睫状体光凝固作为青少年原发性关节炎患者继发性青光眼的首选外科治疗短期随访结果失败率高

目的:评估二极管激光经巩膜睫状体光凝固(TD-CPC)作为青少年原发性关节炎(JIA)患者继发性青光眼的首选外科治疗的成功率。方法:回顾性图表分析观察12例儿科JIA患者伴葡萄膜炎和继发性开角型青光眼。结果:12例患者的21眼患慢性前葡萄膜炎;21眼患继发性开角型青光眼;19眼接受41次     

葡萄膜炎对角膜内皮的影响

长期和严重的内源性葡萄膜炎症,尤其是前葡萄膜炎和全葡萄膜炎,临床上常可见到角膜基质水肿,上皮出现水泡。重者因角膜顽固性水肿会引起角膜血管新生,终致角膜永久性变性和混浊。为了探讨这些临床改变的本质,我们应用角膜内皮显微镜对内源性葡萄膜炎患者的角膜内皮细胞进行了观察,现将结果报告如下:     

无视网膜坏死的巨细胞病毒性虹膜睫状体炎的诊断及治疗

目的:描述不伴视网膜坏死的巨细胞病毒(CM V)性前葡萄膜炎免疫活性患者的诊断和治疗。方法:对2001—2003年伴有继发性青光眼的单眼慢性复发性葡萄膜炎患者,进行包括疱疹病毒实验室检查在内的全面检查。所有患者发病初期即给予特异性抗病毒治疗,并随访评估眼部炎症水平。结果:研     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.