儿童期非外伤性继发性青光眼的发病特征及治疗方式分析  

Analysis of Etiological Characteristics and Treatment Methods of Childhood Secondary Glaucoma Asscioated With Non-Traumatic Diseases

作　　者：吴劲松[1] 熊伟伟[1] 张悦之 WU Jinsong;XIONG Weiwei;ZHANG Yuezhi(Ophthalmic Center,the Second Affiliated Hospital,Jiangxi Medical College,Nanchang University,Nanchang Jiangxi 330006,China)

机构地区：[1]南昌大学第二附属医院眼科中心,江西南昌330006

出　　处：《中国卫生标准管理》2024年第12期26-30,共5页China Health Standard Management

基　　金：江西省卫生健康委科技计划项目(202210633)。

摘　　要：目的探讨儿童期非外伤性继发性青光眼(secondary glaucoma associated with non-traumatic diseases,SCG-NT)的发病特征及治疗方式。方法回顾性分析2018—2021年在南昌大学第二附属医院住院的16岁以下继发性青光眼患儿的病例资料。参考儿童期青光眼网络分类(childhood glaucoma research network classification,CGRN)标准及临床实际,将患儿分为SCG-NT和外伤性继发性青光眼(secondary glaucoma associated with traumatic diseases,SCG-T)2大类。分析患儿性别、发病年龄、累及眼别等一般资料以及SCG-NT患儿的就诊原因、原发病病种、治疗方式等情况。结果纳入儿童期SCG-NT患儿67例70只眼。男性38例,女性29例,平均发病年龄(7.0±4.3)岁,累及单眼64例,累及双眼3例。常见就诊原因是“眼睛红肿”(24例,35.8%)、“发现眼球异常反光”(15例,22.4%)、“视力下降”(13例,19.4%)等。以眼部先天性异常(18例,26.9%)、内眼手术术后(12例,17.9%)、葡萄膜炎(12例,17.9%)等为主要原发病病种。39只眼采取手术治疗,16只眼使用药物治疗,15只眼放弃治疗。结论儿童期SCG-NT患儿发病年龄较小,起病症状不典型。其原发病病种复杂繁多,以眼部先天性异常为最常见。手术是该疾病的主要治疗方式。原发病特点及病程早晚是治疗方式选择及预后的重要因素。Objective To investigate the pathogenesis and treatment methods of secondary glaucoma associated with non-traumatic diseases(SCG-NT)in childhood.Methods The case data of children under 16 years old with secondary glaucoma who were hospitalized in the Second Affiliated Hospital,Jiangxi Medical College,Nanchang University from 2018 to 2021 were retrospectively analyzed.According to the childhood glaucoma research network classification(CGRN)and clinical practice,the children were divided into SCG-NT and secondary glaucoma associated with traumatic diseases(SCG-T).The gender,age of onset,eye involvement and other general data of the two groups were analyzed,as well as the reasons for referral,primary lesions and treatment methods of SCG-NT children.Results A total of 70 eyes of 67 children with SCG-NT in childhood were included.There were 38 males and 29 females.The mean age of onset was(7.0±4.3)years old,64 cases involved one eye,and 3 cases involved both eyes.The common reasons for referral were"red and swollen eyes"(24 cases,35.8%),"abnormal reflection of the eyes"(15 cases,22.4%),and"blurred vision"(13 cases,19.4%).The main primary lesions were ocular congenital abnormalites(18 cases,26.9%),after intraocular surgery(12 cases,17.9%)and uveitis(12 cases,17.9%).A total of 39 eyes were treated with surgery,while 16 eyes were treated with drugs,and abandoning treatment of 15 eyes were found.Conclusion The onset age of SCG-NT in childhood is younger and the onset symptoms are atypical.The primary lesions of the disease are many and diverse,and ocular congenital abnormalities are the most frequent.Surgery is the main treatment method.The characteristics of protopathy and course of disease are important factors in the choice of treatment and prognosis.

关 键 词：继发性青光眼 非外伤性 儿童期 病因 特征 治疗方式 

分 类 号：R775[医药卫生—眼科]