眼科

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83例儿童睑缘炎相关角结膜病变的特征观察

余继锋 刘雪 褚慧慧 李莉   

  1. 首都医科大学附属北京儿童医院眼科 国家儿童医学中心 100045
  • 收稿日期:2019-07-22 出版日期:2020-03-25 发布日期:2020-03-25
  • 通讯作者: 李莉,Email:liliyk1@163.com

Clinical features of blepharokeratoconjunctivitis in 83 children

Yu Jifeng, Liu Xue, Chu Huihui, Li Li   

  1. Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
  • Received:2019-07-22 Online:2020-03-25 Published:2020-03-25
  • Contact: Li Li, Email: liliyk1@163.com

摘要: 目的 探讨儿童睑缘炎相关角结膜病变(BKC)的临床特征。设计 回顾性病例系列。研究对象 2015年11月至2018年11月北京儿童医院BKC患者83例。方法 回顾患者的一般情况、临床症状及体征、误诊原因,治疗均采用睑板腺按摩、热敷等物理疗法,中重度患儿早期使用糖皮质激素滴眼液,记录治疗效果。主要指标 眼睑、睑缘、结膜及角膜的改变及治疗效果。结果 83例患者中位数年龄5.8岁(1~11岁)。女性46例(55.42%)。3~6岁者占42.17%( 35例)。就诊原因中眼红67例(80.72%)、畏光流泪和眼痛39例(46.99%)、分泌物增多30例(36.14%)和揉眼24例(28.91%)。体征中结膜充血83例(100%)、乳头滤泡增生61例(73.49%)、点状上皮浸润61例(73.49%)、新生血管45例(54.22%)。被误诊为角膜炎41例(49.4%)、过敏性结膜炎22例(26.5%)、细菌性结膜炎12例(14.46%)、霰粒肿5例(6.02%)和病毒性结膜炎3例(3.61%)。随访3~25个月,平均(7.3±3.6)个月。67例(80.72%)早期使用糖皮质激素治疗的患儿达到临床痊愈。结论 儿童BKC好发于3~6岁女童,临床症状多样,物理治疗结合早期局部使用糖皮质激素能够显著提高疗效。(眼科, 2020, 29: 157-160)

关键词: 睑缘炎相关性角结膜病变, 儿童

Abstract: Objective To observe the clinical features of blepharokeratoconjunctivitis (BKC) in children. Design Retrospectively case series. Participants Eighty-three BKC patients in Beijing Children's Hospital from November 2015 to November 2018. Methods General conditions, clinical symptoms, signs, misdiagnosis, therapeutic method and clinical efficacy were reviewed. All patients were treated with physical therapy such as meibomian gland massage and hot compress. Glucocorticoid eye drops were used in moderate and severe patients in the early stage. Main Outcome Measures Changes of eyelid, eyelid margin, conjunctiva and cornea, treatment results. Results The 83 BKC patients were aged from 1 to 11 years (median: 5.8years). There were 46 (55.42%) female patients. Most patients occurred in 3~6 years old (35, 42.17%). Ocular redness (67, 80.72%), photophobia, tearing and ocular pain (39, 46.99%), eye secretion (30, 36.14%) and rubbing (24, 28.91%) were the most common complain. The clinical signs were conjunctival hyperemia(83, 100%), papillary follicular hyperplasia (61, 73.49%), punctate epithelial infiltration (61, 73.49%), and neovascularization (45, 54.22%). The BKC had been misdiagnosed as keratitis (41, 49.4%), allergic conjunctivitis (22, 26.5%), bacterial conjunctivitis (12, 14.46%), chalazia (5, 6.02%), and viral conjunctivitis (3, 3.61%). The follow-up time was 3~25 months, average 7.3±3.6 months. There were 67 patients (80.72%) used glucocorticoid and physical therapy earlier achieved clinical recovery. Conclusion BKC in children often occur in 3~6 years old girls. The clinical symptoms are different. Whole course physical therapy combined with early use of glucocorticoid can significantly improve the efficacy. (Ophthalmol CHN, 2020, 29: 157-160)

Key words: blepharokeratoconjunctivitis, children