完善相关辅助检查避免儿童弱视误诊的临床分析  

Clinical Analysis of Perfecting Relevant Auxiliary Examination to Avoid Misdiagnosis of Amblyopia in Children

作　　者：陈嘉锡 何花[1] 杨红[1] 李斌[1] 王志涛[1] 宋琳[1] 肖晓[1] 孙坚[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院眼科,武汉430030

出　　处：《华中科技大学学报（医学版）》2014年第6期692-696,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的：通过分析临床儿童弱视误诊病例，强调相关辅助检查的选择和完善对于避免儿童弱视误诊的重要性。方法回顾分析2013年1月～2013年10月同济医院眼科斜视弱视专科门诊就诊的儿童患者中，既往误诊为弱视但最终确诊为其他疾病的18例病例，并对典型病例进行分析。结果在误诊病例中以先天性的眼底疾病多见，其中缺乏相关的辅助检查、忽视鉴别诊断为主要的误诊原因。结论对于儿童弱视的诊断应慎重，除详细询问病史外，应重视通过必要辅助检查排除眼底及头颅的器质性疾病。另外，对于长期弱视治疗不佳的患儿应进一步查找原因，针对性地选择和完善辅助检查可减少误诊。Objective By analyzing the clinical cases misdiagnosed as amblyopia in children to emphasize on the importance of choosing and completing thorough auxiliary examinations to avoid the misdiagnosis of amblyopia. Methods From January 2013 to October 2013 ,18 children who had been misdiagnosed as amblyopia by grassroots hospitals but diagnosed as other dis‐eases in eye strabismus amblyopia specialist out‐patient clinics of Tongji hospital were retrospectively analyzed ,and the typical cases were specially mentioned.Results Most of the misdiagnosed cases were diagnosed with congenital retinal disease.Main causes for misdiagnosis were the lack of related auxiliary examination and ignorance of differential diagnosis.Conclusion The diagnosis of amblyopia should be discreet.In addition to obtain a detailed medical history ,especially we should attach importance to excluding organic diseases of fundus and head by necessary auxiliary examinations. We should further find the reasons for amblyopia of children having poor curative effects for a long time ,and choosing targeted and thorough auxiliary examination can reduce the misdiagnosis.

关 键 词：弱视  儿童 误诊 视觉电生理检查 影像学检查 

分 类 号：R777.44[医药卫生—眼科] R741.044[医药卫生—临床医学]