中重度儿童睑缘炎相关性角结膜病变临床分析  

Clinical features of moderate and severe blepharokeratoconjunctivitis in children

作　　者：马楠 王丹[1] 李世莲[1] Ma Nan;Wang Dan;Li Shi-lian(Department of Ophthalmology,Wuhan Children's Hospital(Wuhan Maternal and Child Healthcare Hospital),Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院、武汉市妇幼保健院眼科,430014

出　　处：《中国斜视与小儿眼科杂志》2023年第3期24-24,I0001,I0002,I0003,共4页Chinese Journal of Strabismus & Pediatric Ophthalmology

基　　金：武汉儿童医院院级项目(2021FE005)。

摘　　要：目的探讨中重度儿童睑缘炎相关性角结膜病变的临床特点。方法回顾性搜集2013年2月至2023年2月武汉儿童医院BKC住院患儿,与同期单纯疱疹病毒性角膜炎临床特点进行统计分析。结果22例(28眼)中重度儿童BKC中位发病年龄3.4岁,合并睑板腺囊肿12例(54.5%)。对比儿童单纯疱疹病毒性角膜炎,BKC发病年龄更低(Z=3.537,P<0.01),易双眼发病(χ^(2)=4.092,P<0.05),病程更长(Z=-2.379,P<0.05),揉眼频率更高(P<0.05),病灶更易靠近角巩膜缘(χ^(2)=4.875,P<0.05)。14例(63.6%)达到临床痊愈,预后较好。结论儿童BKC误诊率高,需重视低龄儿童中重度BKC的发生。双眼发病、揉眼和周边角膜浸润对于鉴别BKC有临床意义。Objective To investigate the clinical manifestations and treatment outcomes of moderate and severe blepharokeratoconjunctivitis in children.Methods A retrospective,observational study was performed of 22 pediatric in-patients diagnosed with BKC between Feb,2013 and Feb,2023 at Wuhan Children's hospital.Data on the demographic characteristics,clinical symptoms,disease duration,corneal performances and the results of auxiliary examinations were statistically analyzed between children with BKC and herpes simplex keratitis.Results Among the 22 children with moderate to severe BKC,12 children(54.5%)had meibomian gland cyst.Compared to children with herpes simplex keratitis,children with moderate to severe BKC had a lower age of onset(Z=3.537,P<0.01),more common binocular lesion(χ^(2)=4.092,P<0.05),longer course(Z=-2.379,P<0.05),higher frequency of eye rubbing(P<0.05),and more common corneal limbal lesion(χ^(2)=4.875,P<0.05).14 children(63.6%)had clinical recovery.Conclusions Due to the high rate of misdiagnosis on BKC in children,attention should be paid to the occurrence of moderate to severe BKC in young children to avoid amblyopia.Eye rubbing and binocular peripheral corneal lesion have clinical significance in the diagnosis of BKC.

关 键 词：睑缘炎相关性角结膜病变 单纯疱疹病毒性角膜炎 睑缘炎 

分 类 号：R772.2[医药卫生—眼科]