儿童癔症性视力障碍的临床分析与治疗  

Clinical analysis and treatment of hysterical visual impairment in children

作　　者：陈凌燕[1] 钟晖[1] 方旺[1] CHEN Lingyan;ZHONG Hui;FANG Wang(Department of Ophthalmology,Shenzhen Children’s Hospital,Shenzhen Guangdong 518034,China)

机构地区：[1]深圳市儿童医院眼科,广东深圳518034

出　　处：《眼科学报》2022年第10期769-773,F0003,共6页Eye Science

摘　　要：目的:对儿童癔症性视力障碍的病因进行分析,比较试镜与人工泪液给药治疗的疗效。方法:纳入2013年10月至2020年10月以“癔症性突发视力下降”于深圳市儿童医院门诊就诊的36例患儿,其中男16例,女20例。按随机原则分为试镜组与人工泪液给药组。两组在治疗过程中都辅以语言暗示。两组治疗的首次有效率采用SPSS 17.0软件Fisher精确概率检验。分析儿童癔症性视力障碍的发病原因,提出诊断要点和防治对策。结果:在辅以语言暗示的前提下,试镜组与人工泪液给药组治疗方案的首次有效率分别为94.4%、83.3%,差异有统计学意义(P<0.05)。在相关病因分析中,学习压力相关的有20例,占55.6%,包括成绩下降、逃避考试、因成绩受到家长或老师的训斥,甚至体罚。家庭变故13例,占36.1%,父母离异为主要原因。留守儿童不愿返乡、同学纠纷、校园霸凌以及外伤等为其他原因。结论:试镜加语言暗示比人工泪液加语言暗示更能有效提高癔症性视力障碍的首次治疗有效率。学习压力、家庭变故相关因素为癔症性视力障碍的最常见原因。Objective:To analyze the causes of hysterical visual impairment in children,and to compare the efficacy of two treatments of trial frame and artificial tears administration.Methods:A total of 36 children with sudden hysterical visual impairment admitted to Shenzhen Children’s Hospital from October 2013 to October 2020 were enrolled in our study,including 16 males and 20 females.They were randomly divided into trial frame group and artificial tears group.Both groups were supplemented with verbal suggestion during the treatment.The primary effective rates of the two groups were compared by SPSS 17.0 Fisher’s exact test.The causes of hysterical visual impairment in children were analyzed,and the main points of specific diagnostic tests and treatments were summarized.Results:The primary effective rate of the trial frame group and the artificial tears group were 94.4%and 83.3%respectively.The difference was statistically significant(P<0.05).In this study,there were 20 cases(55.6%)related to study pressure,including decline in academic performance,evasion of exams,reprimand by parents or teachers,and even corporal punishment.There were 13 cases(36.1%)caused by family accidents,and parents’divorce was the main reason.Leftover children unwilling to return hometown,classmate disputes,campus bullying and trauma were other reasons.Conclusion:Trial frame is more effective than artificial tears therapy in improving primary effective rate of hysterical visual impairment.Study pressure,family accident are the most common causes of hysterical visual impairment.

关 键 词：癔症 视力障碍 暗示治疗 心理生理性障碍 儿童 

分 类 号：R77[医药卫生—眼科]