婴幼儿泪囊炎临床分析

1．一般情况：我科自1999年1月至2004年4月共诊治婴幼儿泪囊炎660例（702只眼）。男320例,女340例,右眼280例,左眼318例,双眼62例。年龄20天～2个月122例,2～6个月400例,7～12个月116例,1～2岁20例,5岁2例。对660例（702只眼）婴幼儿泪囊炎根据年龄分组;第1组≤6个月,第2组〉6个月。     

婴幼儿泪囊炎的治疗体会

目的　探讨婴幼儿泪囊炎的治疗方法及疗效。方法　对 80例 (91只眼 )泪囊炎患儿采用泪道按摩法、泪道冲洗法和泪道探通术分步进行治疗。 <3个月的新生儿先进行泪道按摩 ;3～ 6个月的患儿 ,经泪道按摩 1周无效时行泪道冲洗 ,连续冲洗 3～ 5次仍不通畅 ,则行泪道探通术。结果　泪道按摩的治愈率为 8.8% ,泪道冲洗的治愈率为 5 9% ,泪道探通的治愈率为 90 %。结论　新生儿泪囊炎患儿应先行泪道按摩治疗 ;泪道探通术疗效最好 ,是泪道冲洗的良好补充。     

空芯探针治疗婴幼儿泪囊炎

婴幼儿泪囊炎临床上较多见,绝大多数通过泪道冲洗或泪道探通术获得治愈,但也有少数非骨性狭窄病例用上述方法效果不佳。我科将自制的空芯探针应用于临床,取得满意效果,现报告如下。１　临床资料以凡用泪道探通术治疗３次不愈者为治疗对象,共１３例,男９例,女４例。右眼８例,左眼５例。年龄为７个月至１岁５个月。本组１３例均自出生后７～１４天内发病,表现为持续流泪伴脓性分泌物。２　方法与结果２－１　试行空芯探针探通术期间,仍坚持滴用抗生素眼液。２－２　用长为６０ｍｍ的７号穿刺针,将其针尖部磨成钝圆,芯为针灸针,尖…     

婴幼儿泪囊炎的治疗综述

婴幼儿泪囊炎是婴幼儿一种常见眼病,其不仅影响眼部外观,而且可引起结膜炎、角膜炎、睑缘炎、泪囊瘘等多种慢性感染,给患儿和家长带来较大的痛苦。对于婴幼儿泪囊炎的治疗时机及治疗方法尚无统一的标准,现就婴幼儿泪囊炎的治疗做一综述。     

婴幼儿泪囊炎探通改进治疗88例

我们于1998～2002年应用在传统探通的基础上做了一些改进的方法治疗婴幼儿泪囊炎88例92眼，全部1次治愈，现报告如下。     

婴幼儿泪囊炎的治疗体会

目的:探讨婴幼儿泪囊炎的治疗方法并总结治疗效果。方法:回顾分析湘西州人民医院眼科诊断为婴幼儿泪囊炎的患儿180例252眼。平均首诊年龄为5.8月龄。联合采用泪囊区按摩、抗生素眼液、泪道冲洗及泪道探通法。随访2～12mo,以溢泪症状完全消失并泪道冲洗通畅作为治愈目标。结果:在180例252眼患儿中,共治愈224眼,治愈率88.89%,其中未经探通而治愈者54眼(21.43%),探通治愈者170眼(67.46%);1次探通即治愈者132眼(52.38%)。此外剖腹产患儿共126例(70%)。结论:婴幼儿泪囊炎多见于剖腹产患儿,早期有效的泪道探通联合泪囊区按摩及抗生素滴眼液是治疗婴幼儿泪囊炎的有效手段。     

不同治疗方式治疗婴幼儿泪囊炎的疗效分析

目的：探讨不同治疗方式治疗婴幼儿泪囊炎的疗效。方法：回顾性收集2013-01/2015-12就诊于我院眼科的婴幼儿泪囊炎患者218例356眼,治疗方式不同分为泪囊区按摩组,泪道加压冲洗组,单纯泪道探通组,泪道探通联合激素冲洗组。观察不同分组患儿的治愈率。结果：随着患儿年龄的增加,总的治愈率呈明显下降趋势;泪道探通组的疗效显著性高于泪道加压组及泪囊按摩组,泪道加压冲洗组的疗效显著性高于泪囊按摩组;联合激素冲洗组疗效显著优于不联合激素冲洗组。上泪小点探通术治愈率显著优于下泪小点探通术。随着患儿年龄的增加,泪囊按摩组、泪道加压冲洗组和泪道探通组的治愈率不断降低(r=0.553、0.437、0.742,P<0.05)。结论：对于月龄较小,1岁以下的患儿首选泪囊区按摩法,而对于1岁~2岁的患儿泪囊按摩无效者推荐泪道探通,上泪小点探通疗效更优,而对于2岁以上患儿多推荐泪道探通联合激素冲洗治疗。     

200例婴幼儿泪囊炎处理体会

一、临床资料1.对象 :本组共 2 0 0例 ,男 90例 ,女 110例 ,2 0例为双眼 ,180例为单眼 ,年龄最小 1个月 ,最大 1岁 ,病程 1个月～1年 ,于出生后出现溢泪、内眦角有分泌物而来就诊。查球结膜无充血 ,角膜透明。2 .方法 :1～ 3个月前 ,患眼滴抗生素眼水 ,泪囊区用棉签做压力按摩 ,每日 2次 ,仍不通畅 ,于 3个月后行泪道反复冲洗 ,利用注入水的压力将膜闭冲破达到治疗目的 ,原则上是以保守治疗 ,如果不奏效 ,则尽早改用泪道探通术 ,术区常规消毒 ,用长冲洗针头 ,先行泪道冲洗 ,将泪囊分泌物冲洗干净 ,顺泪小管走行碰到鼻骨转 90°再往前进针碰…     

婴幼儿泪囊炎治疗分析

婴幼儿泪囊炎在婴幼儿眼病中属常见病。因病原微生物在泪囊中蓄积和繁殖，常导致患儿结膜炎反复发作，长期溢泪导致眼睑湿疹、皮肤皲裂等，多种致病菌有可能对患儿的眼球构成潜在的威胁。婴幼儿泪囊炎治疗的时机和方式的选择对患儿的预后起到非常关键的作用。我科自2002年10月-2006年7月治疗婴幼儿泪囊炎176例，效果满意，现报告分析如下。     

冲通术治疗婴幼儿泪囊炎

目的：观察冲通术治疗婴幼儿泪囊炎的疗效。方法：总结1996年7月－1999年12月作者用冲通术治疗婴幼儿泪囊炎38例44眼，经过半年以上的随访，结果：43眼恢复正常的导泪功能，治愈率97．73％，结论：用冲通术治疗婴幼儿泪囊炎具有简便，安全，疗效高，并发症少的优点，为目前治疗婴幼儿泪囊炎较好的方法。     

A survey of high risk factors affecting retinopathy in full-term infants in China

AIM: To investigate the possible relationship between the influencing factors occurring before and during birth in full-term infants and the outcome of retinopathy. METHODS: Totally 816 full-term infants admitted in the neonate intensive unit of Boai Hospital of Zhongshan between 1 May, 2008 and 30 June, 2011 were included in the study. Fundus examination was performed and evaluated individually on them at the age of 48 hours after delivery, 2 weeks and 1 month. Some possible risk factors happening prenatally or during delivery such as pregnant related hypertension, placenta previa, placental abruption etc, as well as some neonatal risk factors such as neonatal asphyxia, hypoxic-ischemic encephalopathy (HIE), low birth weight etc, were recorded and evacuated. Then the effect of the risk factors of full-term infants on retinopathy was studied. RESULTS: The incidence of retinal hemorrhage of full-term infants with prenatal pregnant related hypertension (PRH) of the mother (43.6%) was significantly higher than that of full-term infants without (8.0%). (P<0.001). The incidence of retinal hemorrhage of full-term infants with neonatal asphyxia and /or hypoxic-ischemic encephalopathy (HIE)(29.3%) was significantly higher than that of those without (15.7%), but correlation was not found between the severity of retina hemorrhage and the degree of hypoxic disease. A pale color of optic disc was associated with a low birth weight of full-term infant. Full-term infants with birth weigh less than 2500g had a significant higher incidence of retinopathy than those with birth weight equal or more than 2500g ( P<0.001). CONCLUSION: The main influencing factors which lead to retinopathy of high risk full-term infants are prenatal factors such as PRH, and some neonatal risk factors such as asphyxia, hypoxic-ischemic encephalopathy, and low birth weight.     

Pathological, immunohistochemical and microbiologicalal analysis of lacrimal sac biopsies in patients with chronic dacrocystitis

AIM:To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial infection and can result in dacryocystitis,which is a constant threat to cornea and orbital soft tissue and a potential source of endophthalmitis following intraocular surgery. The majority of obstructions of the lacrimal excretory outflow system are acquired ones occurring in adulthood and involving the distal parts of the system. Acquired obstruction may be primary/idiopathic or secondary to a wide variety of infectious, inflammatory, traumatic, mechanical, toxic or neoplastic causes mimicking idiopathic inflammation. These cases are treated by dacryocystorhinostomy (DCR).METHODS:The present study was conducted to determine the histopathologic, immunohistochemical and current microbiologic characteristics of lacrimal sac specimens in patients undergoing external dacryocystorhinostomy.RESULTS:Non-specific lacrimal sac pathology was present in all 33 cases and 81.8% of the cases showed moderate chronic inflammation with a chronic inflammatory score (CIS) ranging between 4 and 6, whereas 12.12% showed severe inflammatory changes with a CIS of 7. Mild degree of inflammation was seen in 6.06% with a CIS of 3. The total prevalence of gram-positive, gram-negative, and culture-negative samples were 59.4%, 37.5%, and 3% respectively.CONCLUSION:Non-specific chronic inflammation with fibrosis is indeed the most commonly reported histopathological finding in lacrimal sac wall biopsy specimens.     

鼻窦内窥镜下鼻泪管开口破膜术治疗新生儿泪囊炎

目的探讨鼻窦内窥镜下鼻泪管开口破膜术治疗新生儿泪囊炎的疗效。方法经泪道冲洗5次以上不能治愈的新生儿泪囊炎患者25例（25眼），采用鼻窦内窥镜下鼻泪管开口破膜术治疗。结果23例（25眼）患儿中，溢泪、溢浓症状全部消失，泪道冲洗通畅。结论鼻窦内窥镜下鼻泪管开口破膜术治疗新生儿泪囊炎，安全、有效、实用、并发症少，值得推广应用。     

5039例出生42天婴儿眼病筛查

目的：早期发现婴儿眼病。方法对受检婴儿进行外眼检查,对光刺激反应,瞳孔对光反射,手持裂隙灯眼前节检查,带状光检影镜检查瞳孔红光反射、屈光状态,眼底检查。结果筛查出先天性泪囊炎83例（93眼）,新生儿脓漏眼8例（16眼）,先天性上睑下垂3例（4眼）,眼球震颤4例,先天性白内障4例（7眼）,先天性小眼球小睑裂3例（4眼）,其中1例伴有虹膜脉络膜缺失,先天性无眼球1例（双眼）,先天性青光眼1例（双眼）,屈光异常467例（934眼）,早产儿视网膜病变2例（4眼）。结论早期发现婴儿眼病及干扰视觉功能正常发育的因素,对早期干预,减少视力损害有积极意义。     

Retinopathy of prematurity: a review of risk factors and their clinical significance

Retinopathy of prematurity (ROP) is a retinal vasoproliferative disease that affects premature infants. Despite improvements in neonatal care and management guidelines, ROP remains a leading cause of childhood blindness worldwide. Current screening guidelines are primarily based on two risk factors: birth weight and gestational age; however, many investigators have suggested other risk factors, including maternal factors, prenatal and perinatal factors, demographics, medical interventions, comorbidities of prematurity, nutrition, and genetic factors. We review the existing literature addressing various possible ROP risk factors. Although there have been contradictory reports, and the risk may vary between different populations, understanding ROP risk factors is essential to develop predictive models, to gain insights into pathophysiology of retinal vascular diseases and diseases of prematurity, and to determine future directions in management of and research in ROP.     

先天性白内障近视发生的危险因素分析

目的：探讨先天性白内障近视发生的危险因素,提供预防近视的科学依据。方法：对83例109只先天性白内障眼球的各屈光因子进行生物学测量,确定其屈光状态,并用Logistic回归的方法进行单因素和多因素分析。结果：先天性白内障的近视发和生率是61.27%,眼轴长度为近视发生的主要危险因素,OR＝138.699。结论：尽早去除先天性白内障所造成的形觉剥夺,保持或恢复视觉发育敏感期正常的视觉环境,有利于预防近视的发生。     

Risk and prognostic factors of poor visual outcome in Behcet's disease with ocular involvement

Purpose The purpose of the study was to determine factors correlated with the progression of irreversible visual disturbance in Behcet's disease (BD) with ocular involvement. Methods Forty-seven BD patients with ocular inflammation, who presented with the first ocular episode, and who had been followed continuously for 5–10 years in our hospital, were studied. Charts were reviewed for gender, onset age of uveitis, complete or incomplete type BD, HLA-B51 status, final visual acuity at the last remission period, mean number of ocular attacks per year, and clinical findings of iridocyclitis with profuse hypopyon, strong vitreous opacity blocking the observation of retinal vessels, diffuse retinal vasculitis, and exudates with hemorrhage within the retinal vascular arcade. Results Patients with a visual acuity of ≤20/200 and those with >20/200 differed significantly in the mean number of ocular attacks per year and clinical findings of strong vitreous opacity and exudates within the retinal vascular arcade, but not with regard to the other factors. In addition, the frequency of ocular attacks showed a significant negative correlation with the outcome of visual acuity. Logistic regression analysis indicated a significant association of an average of more than three ocular attacks per year, strong vitreous opacity, and exudates within the retinal vascular arcade with poor visual outcome. Conclusions This study indicates that more than three ocular attacks per year, strong vitreous opacity, and exudates within the retinal vascular arcade are the risk and prognostic factors for a poor outcome of visual acuity in BD patients.     

视网膜母细胞瘤组织浸润程度临床相关危险因素研究

目的探讨视网膜母细胞瘤(Rb)对眼球组织浸润侵犯程度的相关临床危险因素。设计回顾性病例系列。研究对象经组织病理学确诊的Rb患者394例。方法收集1990-2005年北京同仁医院较完整的394例Rb患者的临床病理资料,术前观察主要临床体征,术后光镜下判读Rb眼球各组织浸润程度,通过logistic多元回归分析Rb眼球组织浸润程度的临床危险因素。主要指标Rb各临床体征与眼球组织浸润程度及两者之间的相关性。结果394例Rb中侵犯视盘315例(79．7％),侵犯筛板纤维203例(51．4％),肿瘤穿过筛板至球后视神经内102例(25．8％),侵犯脉络膜102例(25．8％),视神经切除断端受累者26例(6．6％)。统计分析显示:脉络膜组织受累与病程(P=0．032)、结膜充血(P=0．023)、眼球突出(P=0．026)及继发青光眼(P=0．027)有关;视神经切除断端浸润与结膜充血(P=0．008)、虹膜新生血管形成(P=0．033)、眼球突出(P=0．000)有关。结论本组Rb视神经侵犯率较高。病程长、结膜充血、眼球突出是眼球组织侵犯的主要因素。     

正常眼压性青光眼的危险因素

正常眼压性青光眼（normal tension glaucoma,NTG）在临床特征上除了眼压在正常范围外,其余均与开角型青光眼有许多相同之处,故以往一直被认为是开角型青光眼的一个亚型.但随着对此疾病的认识逐渐加深,发现其危险因素与高眼压性开角型青光眼有所不同,全身情况及眼局部因素都对NTG的发生发展产生影响,主要包括性别、年龄、脑供血不足、眼压波动、眼轴长度、屈光度等方面.     

睑板腺功能障碍的相关危险因素

睑板腺功能障碍(meibomian gland dysfunction,MGD)是一种慢性、弥漫性睑板腺异常,它通常以睑板腺终末导管的阻塞和(或)睑板腺分泌物质或量改变为特征.MGD的危险因素错综复杂.任何影响睑板腺功能的原因如局部因素、药物因素、全身情况、先天性因素等均可导致MGD,有时可能为众多危险因素综合作用的结果.临床工作中眼科医生应关注MGD相关危险因素,以便针对性治疗.