中西医结合治疗儿童频繁眨眼86例分析

目的 观察分析中西医结合治疗儿童频繁眨眼的疗效。方法 采用心理疗法、药物、针炙等综合疗法，治疗频繁眨眼患儿86例(172只眼)。结果 通过心理治疗及除去病因后均给以针刺新明Ⅱ、攒竹、四白穴；针刺2次频繁眨眼症状消失者56例(65．11％)，5次频繁眨眼症状消失者28例(32．56％)，10次频繁眨眼症状消失者2例(2．32％)。结论 中西医结合疗法是治疗儿童频繁眨眼的较好方法。     

瞬目频繁患儿病因分析

目的对瞬目频繁患儿的病因进行分析和探讨。方法以主诉为频繁眨眼、眼干涩、痒、不适的162例4～14岁儿童患者为研究对象,分别行基础泪液分泌试验、非侵入性泪膜破裂时间检查、DR-I型干眼仪检查及结膜细胞学检查。结果 162例儿童患者中基础泪液分泌试验检查结果低于10 mm/5 min者88例(54.3%),非侵入性泪膜破裂时间少于10 s者56例(34.3%),干眼仪检查大于等于3级者48例(29.6%),有12例(7.4%)患儿的结膜细胞学涂片中可观察到嗜酸细胞及肥大细胞,提示为过敏性结膜炎。结论瞬目频繁患儿多数是由于干眼症引起的,有少数患儿瞬目频繁与过敏性结膜炎有关。     

儿童异常瞬目综合征的诊治

目的：探讨儿童异常瞬目征的病因及治疗效果。

方法：收集我院门诊2012-07/2015-07收治的频繁瞬目征的儿童,根据问诊及眼部检查结果进行病因分析及相应的治疗,观察其治疗效果。

结果：共收治疗儿童瞬目征患儿5 561例,其中男4 025例,女1 536例,男：女约为2.6：1; 年龄2～14(平均6.9±0.6)岁。病因为屈光不正(远视、近视、散光)共2 054例(36.9%); 过敏性结膜炎1 670例(30.0%); 儿童干眼症982例(17.7%); 偏食及挑食患儿605例(10.9%); 铅污染590例(10.6%); 斜视156例(2.8%); 倒睫者129例(2.3%); 微量元素缺乏(钙、铁、锌、镁、铜)者102例(1.8%); 睑板腺囊肿37例(0.7%); 角膜炎及角膜损伤者24例(0.4%); 眼睑皮炎、过敏性鼻炎、皮炎者37例(0.7%); 结膜结石者8例(0.1%); 抽动障碍者30例(0.5%); 视疲劳者6例(0.1%); 泪道阻塞、泪囊炎者9例(0.1%)。异常瞬目的患儿并不是单一种因素所致,每个患儿经检查其病因均为1种或多种综合因素作用的结果。给予每个患儿行耳穴按摩治疗及心理干预治疗,并在查找病因后给予对症处理。随诊观察1～3mo,瞬目症能明显缓解。其中治愈4 560例(81.9%),好转5 286例,好转率(包含治愈)为95.1%; 略有好转(包含复发病例)102例(1.8%); 无明显变化173例(3.1%)。

结论：多种病因可导致儿童异常瞬目征,屈光不正、过敏性结膜炎及儿童干眼症为其主要原因,针对不同病因进行综合治疗,可得到较好的治疗效果。     

儿童异常瞬目79例临床分析

目的探讨儿童频繁瞬目征的发病原因及其治疗措施、。方法对79例频繁瞬目征的患者治疗进行病因分析。结果通过去除病因、心理治疗等综合治疗措施，95％治愈。结论儿童频繁瞬目征是儿童生长发育中精神障碍的表现，通过病因治疗、心理治疗可取得良好效果，滥用抗生素等眼药水是不可取的。     

儿童异常瞬目87例临床分析

目的探讨儿童异常瞬目征的发病原因及其治疗措施。方法随机抽取在门诊就诊的87例异常瞬目儿童，对其生活习惯及眼部情况作详细询问并记录。结果通过克服不良生活习惯、去除诱因、调节心理等综合治疗措施后，除12例因不配合治疗而无效外，70例（70．9％）1个月内频繁眨眼症状消失，另外5例（5．7％）2个月内频繁眨眼症状亦均消失。结论异常瞬目征与电脑、电视及偏食有一定关系，综合治疗措施是目前治疗本病的较好方法。     

儿童异常瞬目2160例临床分析

目的探讨儿童异常瞬目的发病原因及其治疗措施。方法分析2160例异常瞬目儿童的生活习惯、临床表现及眼部检查结果,并评价治疗效果。结果 2160例异常瞬目儿童中有眼表疾病1693例(78.38%),屈光不正1231例(57.00%)。经对症治疗、克服不良生活习惯、调节心理等综合措施,1411例(70.87%)6个月内频繁眨眼症状消失,304例(15.27%)自觉症状减轻,276例(13.86%)自觉症状无改善。结论眼表疾病和屈光不正是儿童异常瞬目的主要病因,平时不良的用眼及生活习惯是常见的诱因。细致认真的检查及询问病史是做出正确诊断的关键,通过治疗可取得良好效果。     

分析225例儿童异常瞬目的发病原因及治疗方法

目的：分析225例儿童异常瞬目的发病原因及治疗方法。

方法：收集2017 -03/ 2018-03就诊的225例儿童异常瞬目的病因、检查结果、治疗方法和疗效等进行回顾性分析。

结果：收集的225例患儿中,角膜结膜疾病156例(69.3%),其中过敏性结膜炎68例(30.2%),其他角结膜疾病88例(39.1%),眼睑疾患38例(16.9%),屈光不正65例(28.9%),干眼症56例(24.9%),视频终端综合征108例(48%)。经眼科针对病因治疗及克服不良习惯1wk～2mo后,175例治愈,35例好转,15例无改善。

结论：儿童异常瞬目病因较为复杂,与过敏性结膜炎、视频终端综合征、干眼症及屈光不正等关系密切,在临床中应该综合考虑,根据病因不同给予相应治疗。     

阿托品压抑疗法与遮盖疗法治疗儿童屈光参差性弱视

目的:探讨阿托品压抑疗法与遮盖疗法治疗儿童屈光参差性弱视的疗效及对视功能的影响。方法:前瞻性研究。选取2018-02/2020-09本院收治的屈光参差弱视儿童患者158例,采用随机数字表法将弱视儿童分为两组：阿托品压抑疗法组优势眼治疗给予1%阿托品凝胶,临睡前滴一滴至结膜囊内,每周治疗2次者78例;遮盖疗法组弱视儿童每日遮盖优势眼大于2h治疗者80例。比较两组弱视儿童治疗6mo后立体视功能、对比敏感度、行图形视觉诱发电位检测,评估治疗效果及依从性。结果:阿托品压抑疗法组和遮盖疗法组总体依从性比较有差异(96.2%vs 73.8%,P<0.05),有效率比较无差异(79.5%vs 73.8%,P>0.05),立体视功能重建有效率比较有差异(74.4%vs 56.3%,P<0.05)。两组治疗6mo后在1、4、8、10、12c/d频率下对比敏感度较治疗前明显升高(均P<0.001),阿托品压抑疗法组在8、10、12c/d频率下对比敏感度高于遮盖疗法组(均P<0.05),P100波幅高于遮盖疗法组,P100潜伏期低于遮盖疗法组(P100波幅：12.96±2.10...     

婴幼儿眼性斜颈的临床特征与早期手术效果

目的:探讨婴幼儿眼性斜颈的临床特征,评估眼性斜颈早期手术效果。方法:对70例患儿进行回顾性分析。通过获取歪头试验、九方位眼球运动检查及眼底照相的结果,分析眼球肌肉异常的类型,对眼性斜颈做出定性诊断。采用计算机辅助斜视诊断技术,精确测量出水平斜视度数。对眼性斜颈患者中,上斜肌麻痹、下斜肌功能亢进者,行下斜肌部分切除术。其它原因引起的眼性斜颈,根据眼球肌肉异常类型的不同,设计不同的手术方法。对合并水平斜视者以计算机辅助下斜视测量软件测量出的水平斜视角度为根据,定量设计手术。随访时间6～12mo。结果:本组病例中,均找到眼部病因,以单纯性单眼上斜肌麻痹最常见,54例(77%)。全部患儿均接受手术治疗。一次手术后,单纯性单眼上斜肌麻痹患儿,6mo内治愈或改善者53例(占所有单纯性单眼上斜肌麻痹患儿的98%)。所有患儿6mo内治愈或改善者64例(91%),手术失败者6例。其中3例接受第二次手术,术后3例均治愈或改善。合并水平斜视者11例(16%),一次手术后水平斜视全部矫正。结论:婴幼儿眼性斜颈是一组包含不同类型病因的斜视。明确病因后尽早手术可获得满意头位矫正效果。     

儿童弱视综合治疗的疗效观察

目的:探讨儿童弱视综合治疗疗效。方法:不同类型弱视共124例230眼,根据弱视的类型、程度及注视性质,采用先行病因治疗后,再根据病情运用遮盖、压抑、红光闪烁、后像或光刷、精细目力训练,CAM视觉剌激及增视中药离子导入等综合疗法。结果:不同类型弱视的230眼中,痊愈162眼(70.4%),进步62眼(27.0%),无效6眼(2.6%)。结论:对于儿童弱视运用综合治疗方法简便易行,治愈率高,疗效显著,可以推广。     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

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Effects of Adenosine Agonists on Intraocular Pressure and Aqueous Humor Dynamics in Cynomolgus Monkeys

The effects of single or multiple topical doses of the relatively selective A₁adenosine receptor agonists (R)-phenylisopropyladenosine (R-PIA) and N⁶-cyclohexyladenosine (CHA) on intraocular pressure (IOP), aqueous humor flow (AHF) and outflow facility were investigated in ocular normotensive cynomolgus monkeys. IOP and AHF were determined, under ketamine anesthesia, by Goldmann applanation tonometry and fluorophotometry, respectively. Total outflow facility was determined by anterior chamber perfusion under pentobarbital anesthesia. A single unilateral topical application of R-PIA (20–250 μg) or CHA (20–500 μg) produced ocular hypertension (maximum rise=4.9 or 3.5 mmHg) within 30 min, followed by ocular hypotension (maximum fall=2.1 or 3.6 mmHg) from 2–6 hr. The relatively selective adenosine A₂antagonist 3,7-dimethyl-1-propargylxanthine (DMPX, 320 μg) inhibited the early hypertension, without influencing the hypotension. Neither 100 μg R-PIA nor 500 μg CHA clearly altered AHF. Total outflow facility was increased by 71% 3 hr after 100 μg R-PIA. In conclusion, the early ocular hypertension produced by topical adenosine agonists in cynomolgus monkeys is associated with the activation of adenosine A₂receptors, while the subsequent hypotension appears to be mediated by adenosine A₁receptors and results primarily from increased outflow facility.